J. p. SIMONDS 779 



cd intravenous injections of living cultures of colon bacilli. This condition has also been re- 

 ported as the result of injections of living cultures of Staphylococcus aureus by Davidsohn' 

 Lubarsch,^ and Green.J Lyon,^ however, injected rabbits every second or third day for from 

 one to three months with ten-day-old broth cultures of staphylococcus killed with toluol, 

 without the production of amyloid. The belief that amyloid degeneration is due to sublethal 

 intoxications with bacterial products is therefore based largely upon deductions from a study 

 of the condition in human patients in whom it is found associated with some form of chronic 

 infection. But not all cases of such infections are complicated by amyloid disease. Hence 

 there must be some factor other than a bacterial toxic product concerned in its production. 

 M. B. Schmidts thought that amyloid degeneration was closely related to the formation 

 of antibodies because it is seen in horses that have been used for long periods for the com- 

 mercial production of diphtheria antitoxin, and sometimes follows repeated injections of 

 animals with various kinds of bacteria. 



The lesions observed in the kidneys in the usual forms of acute and chronic 

 nephritis (Bright 's disease) are not those which accompany the growth of bacteria 

 in the tissues. It has long been believed, therefore, that these lesions are due to the 

 action of toxic bacterial products rather than the presence of bacteria themselves. 

 It is known that bacteria injected into the blood stream may pass through the kidneys 

 without doing them any appreciable harm.^ Experimental evidence has been sought 

 by many workers for the possible relation between nephritis and bacterial poisons. 

 These experiments have not yielded uniform results. In general, such attempts have 

 resulted in acute changes only. The successful production of experimental chronic 

 nephritis is always rendered problematical because of the frequency with which labo- 

 ratory animals are found to have chronic nephritis. 



Acute degenerative changes in the endothelium of the arterioles and glomerular 

 capillaries have been produced by the injection of diphtheria toxin by Lyon,^ Froth- 

 ingham,^ Bailey,' and others. In addition to the alterations in the endothelium there 

 were frequently found thrombi in the glomerular capillaries, exudate in the glomerular 

 space, and casts in the renal tubules. In no instance were they able to induce a 

 chronic form of nephritis. Fahr" was unable to find in the bodies of persons dead of 

 other diseases long after an attack of diphtheria any evidence that that disease had 

 left any permanent injury in the kidneys. 



Faber" has reported an important difference between the action upon the kidneys 

 of diphtheria toxin alone and in combination with the endotoxin of the colon bacillus. 

 Diphtheria toxin alone produced damage to the endothelium of the capillary tufts, 



' Davidsohn, C: Virchow's Arch.f. path. Anat., 150, 16. 1897. 

 ^'Lubarsch, O.: ibid., p. 471. 



3 Green, A. B.: /. Path. 6° Bact., 7, 184. 1901. 



4 Lyon, G.: ibid., g, 400. 1904. 



s Schmidt, M. B.: Verhandl. d. dtsch. path. Gesellsch., 7, 2. 1904. 



^ Cabot, H., and Crabtree, E. G.: Surg. Gynec. Obsl., 23, 495. 1916. 'Lyon, G.: lac. cit. 



. ^ Frothingham, C: J. Med. Research, 30, 365. 1914. 



« Bailey, C. H.: J. Exper. Med., 25, 109. 191 7. 

 '" Fahr, T.: Ergebn. d. allg. Path. u. path. Anat., 19 (i), 34. 1919. 

 " Faber, H. K.: /. Exper. Med., 26, 139 and 153. 1917. 



