16 TOXINES AND ANTITOXINES. 



the organs of the animal. 1 The poison has then become firmly 

 attached to the organs specifically susceptible to it. Moreover, 

 it is not excreted with the urine (GOLDBERG 2 ). 



When, however, the doses are very large, the poison takes 

 some time to disappear, and can then appear in the urine. 3 This, 

 too, is perfectly explicable by the theory that the receptors are 

 not adapted for such a sudden invasion of enormous quantities 

 of poison, and hence a small proportion of the toxine breaks 

 through the barrier of the kidneys and appears in the urine. 

 The fact that the toxine disappears in the system furnished one 

 of the supports for the conception of the so-called "fermenta- 

 tion theory " of tetanus. According to this, the true toxine first 

 splits off by a secondary reaction within the organism another 

 poison, upon which the anti-body can no longer act (whence 

 tetanus is not curable after the poisoning [vide supra]), and this 

 having no incubation period, acts with the rapidity of an alkaloid, 

 such as strychnine. COURMONT 4 and others claim to have some- 

 times detected such a poison in the organs of the victims of 

 tetanus. We will critically examine this theory in its proper 

 place, and endeavour to show that it is at least superfluous. 

 The disappearance of the toxines on the one hand, and the 

 incurability on the other, can be readily explained by the 

 side-chain theory without the aid of additional hypotheses. 



But all this only applies to susceptible animals. The fate of 

 toxines introduced into the circulatory system of refractory, 

 naturally immune, animals is materially different. 



The question of natural immunity has not yet been completely 

 elucidated in all its details. It is, undoubtedly, an extraordinarily 

 complex phenomenon, and, in particular, its forms of manifesta- 

 tion and its causes show essential differences as regards natural 

 immunity against poisons on the one hand, and against living 

 bacteria on the other. In the case of toxines, we have only to 

 deal with natural antitoxic immunity. 



This can be due a priori to two causes. Either the body of 

 the naturally-immune animal contains antidotes which neutralise 

 the action of the intruding poison, or the cells of the animal are 



1 Salter's assertion (Lancet, 1898, i., 152) that toxines pass into the sweat 

 is not supported by sufficient evidence. 



2 Goldberg, " Ueber Ausscheidung des Tetanusgiftes durch die Nieren- 

 sekretion," Centralbl. f. BaU., xxvi., 547, 1899. But cf. Cobbett (" Excre- 

 tion of Diphtheria Toxine in the Urine," Brit. Med. Journ., 1900, i., 21), 

 who claims to have detected the toxine in the urine. 



3 See in particular Brunner, "Z. Kenntnis d. Tetanusgiftes," Z. f. 1dm. 

 Med., xxxi., 367, 1897. 



4 Of. v. Leyden-Blumenthal, Der Tetanus, Vienna, 1901. 



