TOXINS AND ANTITOXINS 65 



serologically distinct types of dysentery bacilli. Schmitz, for in- 

 stance, found in a dysentery outbreak among prisoners of war in 

 Roumania strains which resembled the Shiga bacillus but were 

 serologically entirely distinct types. Pribram also found that an 

 antitoxin specific for the Shiga-Kruse toxin is inactive toward the 

 toxin of a strain D 118 H (Hallmann). Furthermore, the curative 

 action of anti-dysentery serum is due first to its content in antitoxin, 

 and second to its anti-bacterial properties. 



The serum can further be employed for prophylactic injections in 

 doses from 10 to 30 c.c., but the immunity thus produced will be only 

 of a short duration. Recently Boehneke and Elkeles have inocu- 

 lated over 100,000 persons with a polyvalent bacillary toxin-anti- 

 toxin preparation called dys-bakta, but complete protection was not 

 secured. It was noted, however, that infections occurring in the 

 inoculated individuals were usually of slight severity, and death a 

 very unusual occurrence. The reaction following inoculations was 

 no more severe than that following typhoid inoculations. Immunity 

 thus produced lasted for at least three months. 



Botulinus Toxin and Antitoxin. Bacillus botulinus produces a 

 toxic body leading to symptoms often called " ptomaine poisoning." 

 The toxin, however, is apparently independent of the medium used, 

 is destroyed by moist heat of 58 C. for three hours, and of 80 C. 

 for one-half hour, and is capable of inducing the formation of an 

 antitoxin. The symptoms produced by the toxin are marked in- 

 crease or decrease of saliva flow, vomiting, sometimes diarrhea, 

 but more often constipation, often retention of urine, paralysis of 

 eye muscles, aphoria, rarely fever or disturbance of sensitivity. 

 Death frequently ensues following the appearance of symptoms of 

 bulbar paralysis with disturbances of respiration and heart action. 

 The necropsy shows marked general passive congestion and throm- 

 bosis of the meningeal vessels sometimes with slight hemorrhage. 

 Unlike other toxins, that of botulism resists the digestive juices and 

 is absorbed by way of the alimentary canal. It can be neutralized 

 by brain substance and by the lipoids, lecithin, cholesterol, and by 

 fats, such as butter and oil. It is toxic for man, monkey, cat, rabbit, 

 and guinea-pig. 



The Use of Immune Sera in Botulism. Van Ermengem in 1895 

 discovered the cause of botulism poisoning to be an exotoxin pro- 

 duced by a strictly anaerobic Gram-positive bacillus which he iso- 

 lated from portions of a ham that had caused fifty cases of poisoning 

 at Ellezelles, Belgium. The disease has an exceptionally high mor- 

 tality of almost loo per cent., and up to the present time the per- 

 centage of fatal cases has been as great as it was fifty years 

 ago. The reason for this lies in the fact that the early symptoms of 

 the disease are not recognized until the toxemia is well established. 

 In the year 1897 Kempner showed that susceptible animals may be 

 successfully immunized to the toxins of this organism and obtained 

 a potent antitoxin from goats, I c.c. of the serum protecting against 

 5 



