86 TOXINES AND ANTITOXINES. 



that the toxine attacked the muscle directly, combined with it, 

 and thus injured it. 



As regards individual organs, the following facts are on 

 record : 



Intestine. COURMONT, DOYON, PAViOT 1 observed exudations 

 and enteritis membranacea in the small intestine of dogs. 



Liver. COURMONT, DOYON, and PAVIOT 2 found a hepatitis 

 parenchymatosa, with hypercemia and internal hemorrhage, in 

 dogs after intravenous injection. BALDASSARI 3 observed thick 

 swellings and similar changes, such as occur in poisoning by 

 phosphorus and arsenic. He records the occurrence of epithelial 

 changes in the kidneys. 



Local lesions of the eye similar to those that occur in diph- 

 theria have been observed by MORAX and ELMASSIAN.* GATTI 5 

 has also found that direct contact of diphtheria toxine with the 

 retina produced injuries which led to swelling of the tissue, with 

 conservation of the nuclei and ganglionic cells. 



But, above all, it also causes serious disturbances in the central 

 nervous system, which we cannot describe in detail here. Investiga- 

 tions on this point have been made by ENRIQUEZ and HALLION, G 

 CROCQ fils, 7 THOMAS, 8 MuRAWJEW, 9 and others. 



It is very questionable, however, whether these lesions of the 

 nervous system are to be directly attributed to diphtheria toxine 

 as such. So far as these changes have to do with the diph- 

 theritic secondary paralysis, they must probably be attributed 

 to the toxones. Whether the pure toxine can also produce 

 secondary paralysis, or whether this is only a function of the 

 toxones, cannot be asserted with certainty as yet, although the 

 latter alternative is the more probable. The symptoms of 



1 Courmont, Doyon, and Paviot, "Lesions intestinales dans 1'intoxic- 

 diphth.," Arch, de Phys., xxvii., 484, 1895. 



* Courmont, Doyon, and Paviot, ' ' Lesions hepatiques engendres par la 

 t. d.," Arch, de Phys., xxvii., 687, 1895. 



3 Baldassari, "Ueb. d. Wirkg. d. D.-T. auf den Zellkern," C. f. allg. 

 Pathol.,vn., 625, 1896. 



4 Morax and Elmassian, "Action de la toxine d. sur les muqueuses," 

 Ann. Past., xii., 210, 1898. 



5 Gatti, "L'azione di alcune tossine batteriche sopra gli elementi della 

 retina," abst. by the author in Biochem. CentralbL, L, No. 775, 1903. 



6 Enriquez and Hallion, "My elite exper. par t. d.,"Soc. BioL, xlvi., 312, 

 1894. 



7 Crocq, "S. 1'alterat. du. Syst. nerveux dans 1. paralys. diphth.," Arch, 

 med. exper., vii., 503, 1895. 



8 Thomas, Boston Med. and Surg. J., 1898, No. 4, et seq. 



9 Murawjew, "Des D.-T. u. Antit. in ihrer Wechselwirkg. auf das 

 Nervensystem d. Meerschw.," Fortschr. d. Med., 1898, 93. 



