778 SUBLETHAL INTOXICATIONS 



sublethal doses being quantitative rather than qualitative. Abramow,' working with rabbits, 

 guinea pigs, and horses, found that under the influence of large doses of diphtheria toxin the 

 secretion of adrenalin ceased, with minimal lethal doses it decreased, and with sublethal 

 doses and in immunization it increased. 



Post-diphtheritic paralysis is one of the serious complications of this disease in 

 man, and can be produced experimentally by suitable injections of diphtheria toxin. 

 It is due to the action of the toxin or of the toxon upon the peripheral nerves, giving 

 rise to a peripheral neuritis. This complication occurs in non-fatal cases of this disease 

 in the second or third weeks, after the patient has recovered from the acute symptoms. 

 It is characterized by degeneration of the axis cylinders of the affected nerves with 

 more or less lymphocytic infiltration. 



Many bacterial toxic products cause hyperplasia of lymph glands and spleen. In diph- 

 theria not only are the lymph glands of the neck enlarged, but also those within the abdomi- 

 nal cavity and even the spleen are increased in size. Lymph glands which are regional to 

 and drain a localized focus of infection, such as an abscess due to staphylococci, become 

 enlarged. Inasmuch as bacteria cannot usually be demonstrated in them it is believed that 

 the hyperplasia of such glands is due to the action of toxic products absorbed from the focus 

 of infection. The process is a proliferation of the lymphoid elements and not an infiltration 

 with polymorphonuclear leukocytes such as occurs when the staphylococci themselves reach 

 the gland and set up a purulent inflammation.' 



Tuberculin given in subcutaneous injections, as in the original tuberculin test, causes a 

 focal reaction in the form of a definite and sometimes severe inflammatory reaction with 

 hyperemia and edema in the locally sensitized tissues about tuberculous foci in the lungs 

 and elsewhere. This reaction may sometimes be so severe as to break down the local mecha- 

 nism of resistance and allow a quiescent focus to become active again. 



In many chronic infections, notably in chronic osteomyelitis due to the staphy- 

 lococcus and in tuberculosis of bones, there is frequently found in the smaller arteries 

 and capillaries of the kidneys, liver, spleen, and other organs a deposit of an insoluble, 

 homogeneous, hyaline substance the exact chemical nature of which is in dispute. 

 This is amyloid degeneration. Attempts to produce this lesion experimentally have 

 yielded confusing results. 



Mice have been most frequently used for these experiments. But these animals are espe- 

 cially unsuited for this purpose because of the frequency with which they are found to suffer 

 from spontaneous amyloid degeneration. Thus Simonds^ observed amyloid disease in a con- 

 siderable number of mice from the Slye breeding stock which had never been submitted to 

 experimental procedure of any kind. However, Herzenberg'' found amyloid degeneration in 

 70 per cent of mice which she had repeatedly injected with suspensions of staphylococcus. 

 This percentage is probably much too high for all cases to have been of spontaneous origin. 

 Franks found amyloid disease in an unmentioned number of mice which he had injected with 

 suspensions of B. mucosus capsulatus. Bailey^ produced amyloid disease in rabbits by repeat- 



' Abramow, S.: Ztschr.f. Immunildtsforsch. ti. exper. Therap., Orig., 15, 12. 1912. 



' Symmers, D.: Arch. Int. Med., 21, 237. 1918. 



3 Simonds, J. P.: /'. Cancer Research, g, 329. 1925. 



* Herzenberg, H.: Virchoiv's Arch. f. path. Anat., 260, 466. 1926. 



5 Frank, A.: Beitr. z.- path. Anat. u. z. allg. Path., 67, 181. 1920. 



^ Bailey, C. H.: J. Exper. Med., 23, 773. 1916. 



