VACCINE-THERAPY 139 



body. Some of the poison is also carried along the nerve 

 fibres. In this manner also the motor and sensory nerve 

 cells become severely charged with the poison, producing 

 the characteristic symptoms. This action of the poison is 

 a very difficult one to explain, but probably Ehrlich's side- 

 chain theory supplies the best material that our knowledge 

 of the subject, as we understand it, can give. Accordingly, 

 each toxin molecule is composed of one non-toxic (hapto- 

 phore) and one toxic (toxophore) atom group. The 

 protoplasm of the motor nerve cell is composed of a vital 

 nucleus and numerous side-chains, or receptors, of which 

 many possess a special affinity for the haptophore atom 

 groups of the toxin molecule. When such molecules of the 

 tetanus toxin reach the nerve cells, they are anchored by 

 the aid of the haptophore groups to the corresponding 

 receptors of the cell protoplasm, whereupon the toxophore 

 group attack the nucleus of the cell. The opposed affinity 

 between tetanus toxin and nerve substance is demonstrated 

 by the experimental observation, where it is shown that 

 a mixture of toxin and brain substance is non-toxic for a 

 guinea-pig (Wassermann) . 



When the symptoms of tetanus come on slowly, and the 

 disease itself appears to be running an insidious course, 

 recovery usually follows. On the other hand, if the disease 

 is very acute and the onset rapid, one's prognosis must be 

 unfavourable. 



In the latter condition it is probable the toxin has united 

 with the cells, causing vital destruction; while in the 

 former it may only have fixed itself to the free side-chains, 

 or receptors, or those that are approaching freedom, and 

 thereby neutralizing the toxic effects before cell injury can 

 take place. It must obviously follow when one remembers 

 how potent the toxin of tetanus is ; to obtain any curative 

 results at all, the poison must be neutralized before it 

 begins to attack the cellular elements. This in practice 

 unfortunately is not always possible, as we have no 

 premonitory symptoms to guide us, the first indications 



