BACTERIAL POISONS 45 



cells of tissues capable of binding them would likewise point to more 

 than mere physical union. Nevertheless, it does not by any means 

 exclude the thought that the poisons may, in fact, go into selective 

 relationship with special cells because of physical properties, such as 

 solubility in the lipoidal cell membranes, 50 51 and may subsequently 

 be bound chemically or destroyed by oxidation or enzymotic hydroly- 

 sis after such entrance. In such a case the actual specificity would 

 yet depend on purely physical properties. 



In addition to the specific physical and chemical affinities be- 

 tween the poisons by certain cells there are probably also certain 

 fortuitous factors connected with the distribution and local accumu- 

 lation of the poisons which have some weight in determining the 

 location of injury. For the specific selection is not absolutely strict 

 and there are probably few parenchyma cells in the body that are 

 entirely insusceptible to injury if the poisons are sufficiently con- 

 centrated upon them. Thus, to cite an analog} 7 " from the toxicology 

 of non-bacterial poisons, in lead poisoning, as Meyer and Gottlieb 

 point out, the paralysis of the extensors of the arm occurs chiefly in 

 adults who use these muscles in the exercise of their professions 

 (painters, type-setters), while in children and in animals, in which 

 no such selective use of particular muscle groups is habitual, lead 

 paralyses are atypical, attacking legs as well as arms. It is not un- 

 likely that the frequent injury of the heart muscle by bacterial poi- 

 sons or the irregular parenchymatous changes in various organs is 

 determined by analogous fortuitous factors, in that functional activ- 

 ity and increased metabolism may predispose to injury. 



Bacterial poisons also may produce their lesions in the course of 

 excretion. This seems likely in the case of typhoid poisons in which 

 we have often seen bloody diarrhea in rabbits within a few hours 

 after intravenous injection of powerfully toxic culture filtrates. In 

 connection with the dysentery bacillus Flexner and Sweet 52 have 

 studied the conditions carefully. They succeeded in showing first 

 that the introduction of the dysentery poison into the lumen of the 

 intestine does no harm and that the toxin is slowly destroyed by peptic 

 and tryptic digestion. They concluded that probably no absorption 

 of the poison through the uninjured intestinal mucosa takes place. 

 They then showed that the toxin after intravenous administration 

 is excreted by the intestine and that the inflammatory reactions and 

 injury of the mucosa are incident to this act of elimination. 



Whether or not the kidneys are injured in the same way it -is 

 difficult to decide. In many infectious diseases, of course, the bac- 



50 For Overtoil's theory of osmosis see R. Hober, "Physikalische Chemie 

 der Zelle u. Gewebe," Leipzig, Engelmann, 1911. 



51 Compare also, regarding this entire question, the discussion in P. Th. 

 Miiller, "Vorlesungen iiber Immunitat, etc.," Fischer, Jena, 1910. 



52 Flexner and Sweet. Jour, of Exp. Med., Vol. 8, 1906. 



