378 TETANUS 



of a definite nature to be found. There is congestion, and there 

 may be minute haemorrhages in the areas noted by the naked 

 eye. (The ganglion cells may show appearances which have 

 been regarded as degenerative in nature,) and similar changes 

 have been described in the white matter. The only marked 

 feature is thus a vascular disturbance in the central nervous 

 system, with a possible tendency to degeneration in its specialised 

 cells. Both of these conditions are probably due to the action 

 of the toxins of the bacillus. In the case of the cellular degenera- 

 tions the cells have been observed to return to the normal under 

 the curative influence of the antitoxins (vide infra}. In the 

 other organs of the body there are no constant changes. 



We have said that the general distribution of pathogenic 

 bacteria throughout the body is probably a relative phenomenon, 

 and that bacteria usually found locally may occur generally and 

 vice versa. With regard to the tetanus bacillus it is, however, 

 probably the case that very rarely, if ever, are the organisms 

 found anywhere except in the local lesion. 



(b) The Artificially -produced Disease. The disease can be com- 

 municated to animals by any of the usual methods of inoculation, 

 but does not arise in animals fed with bacilli, whether these 

 contain spores or not. Kitasato found that pure cultures, 

 injected subcutaneously or intravenously, caused death in mice, 

 rats, guinea-pigs, and rabbits. In mice, symptoms appear in a 

 day, and death occurs in two or three days, after inoculation 

 with, a loopful of a bouillon culture. The other animals 

 mentioned require larger doses, and death does not occur so 

 rapidly. (Usually in animals injected subcutaneously the spasms 

 begin in the limb nearest the point of inoculation. In intra- 

 venous inoculation the spasms begin in the extensor muscles of 

 the trunk, as is the case in the natural disease in man.J After 

 death there is found slight hypersemia without pus formation, at 

 the seat of inoculation. The bacilli diminish in number, and 

 may be absent at the time of death. The organs generally show 

 little change. 



Kitasato states that in his earlier experiments the quantity of 

 culture medium injected along with the bacilli already contained 

 enough of the poisonous bodies formed by the bacilli to cause 

 death. The symptoms came on sooner than by the improved 

 method mentioned below, and were, therefore, due to the toxins 

 already present. In his subsequent work, therefore, he employed 

 splinters of wood soaked in cultures in which spores were present, 

 and subsequently subjected for one hour to a temperature of 

 80 C. The latter treatment not only killed all the bacilli, but, 



