1. Local Shwartzman reaction: 24 hours after injection of typhoid bacilli filtrate into rabbit skin, the same filtrate was injected into its vein, and about 4 hours later, hemorrhage and necrosis occurred at the intradermal injection site. Such as intradermal injection of meningococcal filtrate and intravenous injection of Escherichia coli filtrate can also cause the same reaction. It shows that the reaction is not caused by antigen-antibody binding but caused by gram-negative bacterial endotoxin, which causes the increase in vascular permeability, blood cell adhesion, and plasma exudation at the injection site. If the endotoxin is injected from the vein again, a large number of blood cells will gather at the initial injection site, aggravating the lesion and producing hemorrhagic necrotizing inflammation.

2. General Shwartzman reaction: diffuse intravascular coagulation (DIC). It means that if the animals are injected with a small dose of non-lethal endotoxin intravenously every 24 hours, the animals will have a tendency to shock or bleed after the second injection, or even die due to acute renal failure. Postmortem anatomy revealed that fibrinous micro thrombosis is often found in various important organs, which resulted in ischemic necrosis of corresponding tissues, especially in the kidney, lungs, liver, and other organs.

If thorium dioxide, which has the function of blocking the mononuclear phagocyte system, is used to replace endotoxin in the first injection, DIC will also occur after the second injection of a small dose of endotoxin. At present, it is generally believed that one of the mechanisms of systemic Shwartzman reaction is that the mononuclear-phagocyte system is blocked after the first injection of endotoxin because it engulfs endotoxin and fibrin, which inhibits its function while the body is in a state of high coagulation and low fibrinolysis. Therefore, during the second injection, the ability of phagocytosis of activated coagulation factors in the mononuclear-phagocyte system can not inactivate the endotoxin due to the reduction. Endotoxin can activate coagulation factor XII, promote platelet aggregation and constrict blood vessels, so it can cause DIC in many ways.