464 PATHOGENIC MICROORGANISMS 



Tetanolysin. Tetanus bouillon contains, besides the "tetano- 

 spasmin" described above which produces the familiar symptoms of the 

 disease, another substance discovered by Ehrlich 1 and named by him 

 " tetanolysin." Tetanolysin has the power of causing hemolysis of 

 the red blood corpuscles of various animals, and is an entirely separate 

 substance from tetanospasmin. It may be removed from toxic broth 

 by admixture of red blood cells, is more thermolabile than the tetano- 

 spasmin, and gives rise to an antihemolysin when injected into animals. 

 For the production, standardization, and use of tetanus antitoxin, see 

 p. 220 et seq. 



Therapeutic Value of Tetanus Antitoxin. Until recently tetanus 

 antitoxin was chiefly useful as a prophylactic, from 1,000 to 5,000 units 

 being given by deeply subcutaneous or intramuscular injection. Its 

 use after the onset of symptoms had, however, been fraught with much 

 disappointment, largely because it was not possible to influence the toxin 

 which had already become united with the substance of the nerve tis- 

 sues. Recently, however, more perfect methods of administration have 

 been devised with which better results have been achieved. The most 

 successful of these seems to be the method of Park and Nicoll. 2 They 

 carry out a spinal puncture taking off a moderate amount of spinal fluid, 

 and then inject slowly by gravity from 3,000 to 5,000 units of tetanus 

 antitoxin in a volume of from 3 to 10 c.c. At the same time 10,000 

 units are given intravenously or intramuscularly. 



1 Ehrlich, Berl. klin. Woch., 1898. 



8 Park and Nicoll, Jour, of the A. M. A., vol. 63, July, 1914, p. 235. 



