36 QUATERCENTENARY STUDIES IN PATHOLOGY 



figuration. In the case of Tetanus, the symptoms are induced by the 

 absorption of a toxine secreted by the bacillus of the disease. The 

 organism exerts its evil influence only when introduced into a wound ; when 

 administered by the mouth it is apparently harmless. So universally is 

 the organism distributed in nature that we must be constantly swallowing 

 it, and yet no ill effects follow. 



There is another variety of tetanus which is known as " idiopathic," 

 mainly because we know nothing of its pathology, and in which there is 

 an absence of any wound of the surface, or other apparent point of 

 entrance. It has always been assumed that the organism inducing this 

 idiopathic variety is the same as that occurring in the traumatic form. 



In view, however, of this disease, chorea paralytica of the sheep, 

 being so closely allied with tetanus, both with regard to the organism 

 producing it and in the character of the symptoms occasionally evoked, 

 I would be inclined to pause before admitting the truth of this allegation. 

 May it not be a disease caused by an organism of the same class as that 

 producing chorea paralytica, but intestinal in its habitat, as the organisms 

 instrumental in producing all the members of this class of diseases of 

 the sheep are? And may it not happen that it is a common inhabitant 

 of the intestine, but that only in certain susceptible individuals gets over 

 from the channel of the bowel into the blood, becomes bacteriolysed, 

 and so allows the toxines bound up with its protoplasm to escape, these 

 again acting on the nerve cells with which they have a combining 

 affinity ? 



Tetanus of the new-born is also a form of the disease of whose 

 pathology we have no conception, and I would go so far as to suggest 

 that it may be the result of the action of such an intestinal anaerobe to 

 which the infant as yet has not become immunized. 



Chorea, Epilepsy, and Insanity. 



The same principles applied to chorea seem to me to afford a very 

 likely explanation of its pathology. The human disease presents many 

 points of resemblance to chorea paralytica of the sheep, and perhaps it 

 is not going beyond the mark to suppose that this disease of man like 

 that of the sheep is also intestinal in its point of origin, that the same 

 principle is at work in its production as in chorea paralytica of the sheep, 



(3<5) 



