368 Chapter XII 



Kitashima, also collected a large number of analogous facts. They 

 showed that horses that have been treated for a long time with 

 tetanus toxin and whose blood serum is very antitoxic, still experience 

 marked illness after fresh injections of toxin and may even succumb, 

 in spite of the presence of a large amount of antitoxin in their blood. 

 In these cases the morbid phenomena are undoubtedly different from 

 those typical of tetanus. Instead of the muscular contractions which 

 characterise this disease, the above observers noted disturbance in 

 the regulation of the body temperature, exudative inflammation 

 around the point of inoculation, impairment of appetite and fall of 

 body weight. Sometimes they observed muscular tremors and marked 

 feebleness in the movements. These symptoms differing from those 

 of typical tetanus, it may be asked whether this poisoning is not due 

 to special substances other than tetanus toxin in the fluids injected. 

 Von Behring does not think that this is the case, for he found that 

 by adding antitetanus serum the formation of exudations at the seat 

 of inoculation was suppressed. These exudations, then, must be 

 attributed to the tetanus toxin. 



In the cases where animals immunised against diphtheria toxin 

 fall ill and even die as the result of fresh injections of toxin, in spite 

 [387] of the presence of a large quantity of antitoxin in their blood, we 

 might also cast doubts on the diphtheritic character of the poisoning, 

 because the clinical picture of this poisoning is not a very typical one. 

 At the Pasteur Institute, where a large supply of antidiphtheria 

 serum is prepared, we see, from time to time, horses, which have long 

 been undergoing the process of immunisation and are furnishing a 

 very good serum, suddenly fall ill and die from intoxication, without 

 presenting any symptom of infective disease. On one occasion, there 

 was actually quite a small epidemic of fatal poisonings as the result 

 of the injection of a quantity of diphtheria toxin not exceeding the 

 doses which had been well borne previously. Amongst the horses, 

 inoculated with the same toxin, five of the best furnishers of serum 

 died. The others, some of which were producing only a weak serum, 

 remained unaffected. 



Von Behring and Kitashima 1 have given a detailed history of a 

 young horse which had become very susceptible as the result of 

 vaccination with diphtheria toxin. It finally succumbed to the intoxi- 

 cation in spite of the presence of diphtheria antitoxin in its blood. 



If, in these examples, we have any reason to doubt the specific 

 1 Berl. klin. Wchnsclir., 1901, S. 157. 



