IMMUNITY TO TOXINS 117 



for example, the severity of the symptoms due to an abscess due 

 to B. coli and the lack of symptoms due to the absorption of the 

 toxins of this organism which occurs from the alimentary canal, 

 and very probably from bacilli which actually make their way 

 through its walls into the lacteals. There can be but little doubt 

 that the symptoms of intoxication in the former case are due to 

 the direct access of the bacterial poisons into the blood-stream 

 without having first to traverse the liver. Again, in a case of 

 diphtheria of moderate severity virulent bacilli are often present 

 in abundance so great, that by comparison with the toxin-forming 

 powers of the organisms in vitro we might expect a rapidly fatal 

 issue from the toxin absorbed, and yet the symptoms of general 

 intoxication may not be severe. In all probability only a small 

 fraction of the toxin formed actually reaches the distant tissues. 

 Some may be dealt with by the zone of leucocytes which under- 

 lies the layer of diphtheria bacilli, but it is also possible that some 

 of the toxin is destroyed in the blood-stream, perhaps by a process 

 of oxidation. These non-specific methods of dealing with toxins 

 are matters more for the physiologist than for the pathologist, 

 depending as they do simply on the perfect discharge of the 

 normal functions of the body. They are of great importance 

 greater, perhaps, than pathologists usually realize, the interest 

 attaching to them being so much less than that which is connected 

 with the study of the antitoxins and similar bodies. They are to 

 be regarded as the first line of defence against poisons of all sorts. 

 When a small dose of a specific bacterial toxin gains access it is 

 probable that the natural physiological methods in daily use for 

 dealing with the natural poisons (formed in metabolism or absorbed 

 from the alimentary canal) are in most cases applicable to it also, 

 and no specific process has to be brought into action. In confir- 

 mation of this view is the fact that diphtheria antitoxin is not 

 necessarily found in the blood after natural recovery from diph- 

 theria, suggesting that in these cases the processes at work are 

 non-specific. 



But when the toxin is present in greater amount this process 

 may fail, and it may do so in consequence of the action of the 

 poison on the tissues and organs normally concerned in the defence 

 of the body. The neutralization of toxins, etc., in the liver and 

 other regions can be carried out best when these organs are in a 

 state of high functional activity, and when this is impaired some 

 of the deleterious substances will escape their action. Thus we 



