30 Researches on Tetanus. [May 7, 



injected limb or its nerve are exaggerated, though from all other parts 

 of the body only normal reflexes are excited. 



If the intoxication proceeds further the motor tonus, as well as the 

 increased reflex irritability spreads, and rigidity of almost all the 

 striped muscles and general reflex tetanus set in. 



The tetanus of warm-blooded animals consists, in fact, of two 

 processes separated from each other both in time and space. Of these 

 the one is primary, a motor intoxication : local muscular rigidity ; the 

 other, secondary, is a local sensory intoxication : a diffused reflex 

 tetanus, starting from the intoxicated neuron. 



VII. The Behaviour of Tetanus Anti-toxine in the Organism. 



We found in repeated experiments that when tetanus toxine was 

 introduced direct into a- motor nerve, anti-toxine, though present in 

 large quantities in the blood, was unable to prevent the outbreak of 

 the disease or even to hinder a fatal issue. This was the case both 

 when large doses of anti-toxine were given before and after the toxine, 

 as well as when an actively immunised animal was employed. 



We conclude, therefore, that injected anti-toxine does not reach the 

 substance of the nerve fibrils and centres, and that even with highly 

 immunised animals the nevrons remain free from anti-toxine. 



On the other hand, it has been shown that the cerebro-spinal fluid, 

 and, therefore, the nerve lymph of an immunised animal contains 

 anti-toxine, there remains, therefore, only the fibril plasma as carrier of 

 the toxine. We are further inclined to think that, in face of the facts 

 revealed by our researches, it is difficult to look upon the nervous 

 system as the source of tetanus anti-toxine. 



As regards the value of the serum treatment of tetanus, it is clear, 

 from what has been said above, that any toxine which is already in the 

 nerve substance, though not yet in the spinal cord, cannot be reached 

 and neutralised by anti-toxine, whether given under the skin or direct 

 into the blood. An attack corresponding to the amount of toxine 

 absorbed by the nerves will infallibly break out and run its course in 

 spite of the anti-toxine. On the other hand, the toxine still in the 

 blood and lymph will be rendered harmless by an injection of anti- 

 toxine, the absorption of fresh toxine from the infected wound hindered, 

 and in this way an otherwise fatal result may be prevented and the 

 life of a tetanus patient saved. 



NOTE. A full report of these researches will appear in Schmiedeberg's 

 1 Archiv f . experiment. Pathologic und Pharmakologie/ 



