88 TOXIN AND ANTITOXIN 



Also in regard to the efficiency of serum therapy in tetanus 



Serum opinions differ. There is, however, no doubt that a certain 

 Iherapy of .. 



Tetanus amount of reliance can be placed upon this treatment. Fail- 

 ures in successful application are ascribed to the different 

 paths by which the toxin and antitoxin travel. The former is carried 

 by the nerve fibers, the latter by the blood stream. Thus the serum 

 instead of being given subcutaneously, as is the general rule, is admin- 

 istered by intraneural, intracerebral, and subdural injections. 100 to 

 200 units should be injected subcutaneously at the site of the infection 

 or its vicinity and in addition the nerve fibers supplying the infected region 

 should be exposed and inoculated with moderate doses of antitoxin at 

 various points along their centripetal course. 



The prophylactic use of tetanus serum has met with better results. 

 Behring advises the administration of ten to twenty antitoxin units 

 subcutaneously. Calmette sprinkles upon the open navel at birth a 

 powder made of dried serum as a prophylactic against tetanus neonatorum. 

 Bockenheimer advises an ointment containing the antitoxin as a dressing 

 for suspicious wounds. 



The Botulism toxin is the poison produced by the bacillus 



Botulism botulinus. This is the exciting agent of a type of meat and 



Toxin. sausage poisoning described by van Ermenghem in 1896 as 



Botulism. The bacillus botulinus is a very actively motile 



anerobic bacterium which grows at room temperature and presents 



marked gas and toxin formation. A medium in which the toxin is readily 



produced consists, according to Ermenghem, of an alkaline bouillon made 



in the form of an infusion from ham with the addition of i per cent, of 



glucose, i per cent, of peptone and i per cent, of sodium chloride. 



The toxin can be demonstrated after 3 weeks of growth, and is then 

 obtained by bacterial filtration. The cultures have a sour odor like 

 butyric acid. The toxin deteriorates easily when exposed to air and 

 light. It is therefore preserved in brown, sealed vials, and kept on ice; 

 or in a dried form in vacuum. Heating the toxin for three hours at 

 58 C. or one-half hour at 80 C. destroys its toxicity. 



Acting unrestrained, the botulism toxin is one of the severest of poisons. 

 It affects susceptible animals even in minutest doses. In contradistinc- 

 tion to other toxins it is fatal even when taken per os. 



The characteristic symptoms produced by botulism intoxication consist of hyper- 

 secretion of mucus from the mouth and nose, paralysis of eye muscles, urine retention, 

 obstipation, dysphagia, aphagia, and aphoria. No fever, nor any sensitory disturb- 

 ances are in evidence. Death takes place because of bulbar paralysis accompanied by 

 respiratory and cardiac failure, 



The poison is absorbed or arrested in the central nervous system, o.i 



