BACTERIAL POISONS 31 



terial toxemia as manifested in disease. In the first place it is 

 doubtful whether ptomains, in noticeable quantity, are ever produced 

 within the living infected body. Then, again, potent ptomains are 

 produced in culture by many bacteria having absolutely no patho- 

 genic power, while highly pathogenic bacteria may produce little or 

 no ptomains. Ptomain production, moreover, is not specific, since 

 the same ptomains may be produced by many different bacteria or 

 mixtures of bacteria, provided the conditions of nutrient materials 

 and temperature are favorable for growth. We cannot therefore 

 account for bacterial toxemia, in which the poison produced bv an 

 individual species is characteristic and invariably the same, under 

 varying cultural and environmental conditions, by the production of 

 ptomains. And even when ptomains are produced in culture fluids 

 by pathogenic bacteria their physiological action is usually quite 

 different from that of the poisons produced by the same micro-organ- 

 isms in the infected subject. 



Briefly summarized, therefore, the ptomains are poisons elab- 

 orated by all bacteria that are capable of producing protein cleavage, 

 if planted on suitable nutrient materials under conditions favoring 

 growth. The matrix of these poisons is the protein nutriment ; they 

 are not products of intracellular metabolism specifically characteris- 

 tic of the bacteria which produce them. 



Their importance in the production of disease, therefore, is really 

 an indirect one. They may cause disease if putrid meat or other 

 material is ingested, and with it preformed ptomains, which may be 

 taken in and further elaborated by continued putrefaction in the 

 intestines. This form of meat poisoning, without bacteriological in- 

 vestigation, may be difficult to distinguish from such bacterial forms 

 of meat poisoning as those caused by the Gartner bacillus or the 

 bacillus botulinus. Novy 10 believes that true ptomain poisoning of 

 this kind is rather less frequent than formerly supposed. However, 

 in such cases as those of Vaughan, who isolated a poisonous ptomain 

 "tyrotoxicon" from cheese and milk, their importance seems rea- 

 sonably certain. It is also probable that certain forms of auto- 

 intoxication may be caused by the production in the intestinal ca- 

 nal of ptomains resulting from bacterial putrefaction incident to 

 faulty digestive conditions. It is the antagonism to such intes- 

 tinal putrefaction by the acid production of the bacillus Bul- 

 garicus which is probably the basic cause of any favorable thera- 

 peutic effects which have attended the soured milk therapy of 

 Metchnikoff. Again the growth of saprophytes in necrotic tissues 

 such as gangrenous extremities in diabetes or amputation stumps, 

 may lead to the formation of ptomains which, after absorption, can 

 cause disease. In all such cases the process is one determined by the 

 bacterial putrefaction of dead organic materials, and the absorbed 

 10 Novy in Osier's "Modern Medicine," Vol. 1, p. 223. 



