740 PATHOGENIC MICROORGANISMS 



ourselves to the intraspinal method developed in this country by 

 Park and Nicoll, 41 and in France by Doyen, and gradually coming 

 into general use. As advised by Park and Nicoll, a spinal puncture 

 is made and a moderate amount of spinal fluid taken out. Then, 

 slowly by gravity from 3,000 to 5,000 units of tetanus antitoxin are 

 injected until a total amount of 3 c.c. has been reached, the amount 

 injected approximately replacing the amount of fluid withdrawn. 

 At the same time, 10,000 units are given intravenously or intramus- 

 cularly. This procedure must be repeated according to indications. 

 For other forms of treatment such as carbolic acid injections, 

 magnesium sulphate, etc., we must refer the reader to books on 

 surgical therapy. 



BACILLUS BOTULINUS 



Meat poisoning was formerly regarded as entirely dependent 

 upon putrefactive changes in infected meat, resulting in the 

 production of ptomains or other harmful products of bacterial 

 putrefaction. It was not until 1888 that certain of these cases were 

 definitely recognized as true bacterial infections, in which the pre- 

 formed poison probably aided only in establishing the infection. 

 Gartner, in that year, discovered the Bacillus enteritidis, a micro- 

 organism belonging to the group of the paratyphoid bacilli, and demon- 

 strated its presence both in the infecting meat and in the intestinal 

 tracts of patients. The characteristics of this type of meat poisoning 

 have been discussed more particularly in the section describing the 

 bacillus of Gartner and its allied forms. 



There is another type of meat poisoning, however, which is not 

 only much more severe, but is characterized by a clinical picture 

 more significant of a profound systemic toxemia than of a mere 

 gastroenteric irritation. The etiological factor underlying this type 

 of infection was first demonstrated by Van Ermengem, 42 in 1896, 

 and named Bacillus botulinus. Van Ermengem isolated the bacillus 

 from a pickled ham, the ingestion of which had caused disease in 

 a large number of persons. Of the thirty-four individuals who had 

 eaten of it, all were attacked, about ten of them very severely. Van 

 Ermengem found the bacilli in large numbers lying between the 

 muscle fibers in the ham, and was able to cultivate the same micro- 



41 Park and Nicoll, Jour. A. M. A., 63, 1914, 245. 



42 Van Ermengem, Cent, f, Bakt., xix, 1896; Zeit. f, Hyg., xxvi, 1897. 



