54 BACTERIAL POISONS 



that insofar as a direct chemical effect upon the cells of the body 

 is concerned, this can only take place if a mutual affinity exists 

 between such cells and the toxic substances or their 'derivatives. 

 But it does not follow that because of such a mutual affinity a 

 toxic effect must of necessity result. This can only occur if the 

 combination with the toxic principle implies a toxic effect. If, then, 

 we observe a toxic effect clinically, upon the central nervous system, 

 for example, this does not necessitate the conclusion that the toxin 

 does not act upon other structures of the body also, but clinically 

 the toxic effect is, of course, the only effect which excites our attention. 



Remembering the curious interaction between different organs, 

 however, the thought naturally suggests itself that the toxic bacterial 

 products might exert a toxic effect not only directly but also indi- 

 rectly. This possibility has apparently not received the attention 

 which it deserves, but must nevertheless be borne in mind. It is 

 perfectly conceivable that a toxin might act upon a certain organ 

 in a way to impair its function, without actually endangering the 

 integrity of the cells as such, but that the impairment of its function 

 may carry in its trail secondary effects which become apparent to 

 the clinician at once, while the primary action escapes attention. 

 Every physician is familiar with the effect of various infections upon 

 the gastro-intestinal functions, on the occurrence of constipation 

 defective secretion of hydrochloric acid, etc., factors which we now 

 know to be controlled to a large extent, if not entirely, by hormone 

 action, and it is clear in view of the interdependence of the gastro- 

 intestinal hormones, that interference at any one point in the chain 

 might readily upset the digestive equilibrium and lead to various 

 further disturbances of the metabolism. 



Then, again, as I have already pointed out, there is a. certain danger 

 from the action of those very products (antibodies) which the body 

 itself forms, primarily no doubt as a defensive reaction, against the 

 products derived from the bacteria and of which more will be said 

 in later chapters. It is clear at any rate that the picture of the infec- 

 tious disease is unquestionably the composite of more factors than 

 we are apt to think on first consideration, and some of which no 

 doubt will be found to explain such symptoms as the mysterious 

 death from anthrax, for example, where evidences of actual disease 

 are wanting until the end is near, and where the first symptoms are 

 practically the last ones. To explain this point, undue prominence 



