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The diagnosis of systemic reactions to insect stings usually presents no difficulty by history and as a rule the diagnosis has been made before the allergist sees the patient. A differentiation between local and systemic reactions should be made, and although systemic reactions are frequently preceded by increasingly large local reactions with previous stings, a great many people have large local reactions accompanying successive stings, over many years, without ever developing systemic sensitivity.
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Harry Louis Mueller (1966) studied this question.
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