VARIETIES OF CYTOTOXINS 539 



of the cytotoxins. As shown by Pearce, with the aid of this serum 

 physiologic and anatomic alterations and lesions are readily studied. 

 The injection of a nephrotoxic serum produces a tubular nephritis, with 

 albuminuria and possibly hemoglobinuria. The serums are usually 

 hemolytic, and frequently cause degenerative lesions in the liver, due in 

 part to hemolysis and hemagglutination of red corpuscles. 



5. Hepatotoxin.^Delezerme l was the first to work with the so-called 

 hepatotoxin, which, he claimed, possessed absolute organ specificity. 

 Subsequent investigations, however, have brought forth contradictory 

 findings. Pearce found that hyaline thrombi, formed of agglutinated 

 red corpuscles, are primarily responsible for the areas of necrosis and 

 hemorrhage, with secondary effects, which may be ascribed to a cytotoxin 

 liberated chiefly by the cells in the thrombus, and acting on the liver- 

 cells. These findings and views have recently received support from 

 the investigations of Karsner and Aub. 2 



6. Gastrotoxin. Gastrotoxic serums have been studied by Bolton, 3 

 who immunized rabbits with emulsions of the mucosa of the stomach 

 of the guinea-pig. The injection of this serum into guinea-pigs was 

 followed by the development of areas of hemorrhage, necrosis, and ulcer 

 formation that resembled peptic ulcers. According to Bolton, if the 

 gastric secretions were neutralized with large quantities of alkali, the 

 ulcers did not develop, indicating that the peptic ferments may be oper- 

 ative in the digestion of the cells after their destruction by the immune 

 serum. Gastrotoxic serums were found to produce precipitates with 

 clear filtrates of gastric cells, and were also shown to be hemolytic. 



7. Synocytotoxin. This serum has been produced experimentally 

 by immunization with an emulsion of placental cells. According to 

 Liepmann, 4 it produces a precipitate with a filtrate of placenta cells, and 

 at one time it was believed that it might constitute a diagnostic test for 

 pregnancy. 



Syncytotoxins are interesting as considered in reference to eclampsia 

 and other toxemias of pregnancy. As is well known, placental cells 

 may become detached and, gaining entrance to the circulation, become 

 lodged in remote organs (Schmorl). This has given rise to the theory 

 that a placentotoxin is developed that produces the nephritis of preg- 

 nancy and necrotic lesions in the liver. Weichardt asserts that, by 

 digesting placenta in vitro with an active placentotoxic serum and in- 



1 Semaine Med., 1900, xx, 290. 2 Jour. Med. Research, 1913, xxviii, 377. 



3 Proc. Roy. Soc., Ixxvii, 426, and Ixxix, 533. 



4 Deutsch. med. Wochenschr., 1902, xxviii, 911. 



