BOTULISM TOXIN. 8 1 



In regards to the efficiency of serum therapy in tetanus, 



TherT^of P inions differ - There is, however, no doubt that a certain 



Tetanus. amount of reliance can be placed upon this treatment. Failures 



in successful application are ascribed to the different paths by 

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

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

 of being given subcutaneously, as is the general rule, is administered 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 subcutane- 

 ously. Calmette sprinkles upon the open navel at birth a powder made of 

 dried serum as a prophylactic against tetanus neonatorum. Bocken- 

 heimer advises an ointment containing the antitoxin as a dressing for sus- 

 picious 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 glu- 

 cose, i per cent, of peptone and i per cent, of NaCl. 



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

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

 butyric a :id. 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 or one-half 

 hour at 80 destroys its toxicity. 



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

 It affects susceptible animals even in minutest doses. In contradistinction 

 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 sensatory disturbances 

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

 spiratory and cardiac failure. 



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

 c.c. of an emulsion of central nervous tissue neutralizes three times the fatal 

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