368 DIPHTHERIA. 



culture fluid. Brieger and Boer have separated from 

 diphtheria cultures a toxic body which gives no proteid 

 reaction (vide p. 157). 



Toxic bodies have also been obtained from the tissues of 

 those who have died from diphtheria. Roux and Yersin, by 

 using a filtered watery extract from the spleen from very 

 virulent cases of diphtheria, produced in animals death after 

 wasting and paralysis, and also obtained similar results by 

 employing the urine. The subject of toxic bodies in the 

 tissues, however, has been specially worked out by Sidney 

 Martin. He has separated from the tissues and especially 

 from the spleen of patients who have died from diphtheria, 

 by precipitation by alcohol, chemical substances of two 

 kinds, namely, albumoses (proto- and deutero-, but especially 

 the latter), and an organic acid. The albumoses when 

 injected into rabbits especially in repeated doses, produce 

 fever, diarrhoea, paresis, and loss of .weight, with ultimately 

 a fatal result. As in the experiments with the toxine from 

 cultures, the posterior limbs are first affected ; afterwards 

 the respiratory muscles, and finally the heart, are impli- 

 cated. He further found that this paresis is due to well- 

 marked changes in the nerves. The medullary sheaths 

 first become affected, breaking up into globules ; ultimately 

 the axis cylinders are involved, and may break across, so 

 that degeneration occurs in the peripheral portion of the 

 nerve fibres. Such changes occur irregularly in patches, 

 both sensory and motor fibres being affected. Fatty change 

 takes place in the associated muscle fibres. There may 

 also be a similar condition in the cardiac muscle. The 

 organic acid has a similar but weaker action. Substances 

 obtained from diphtheria membrane have an action like 

 that of the bodies obtained from the spleen, but in higher 

 degree. Martin considers that this is due to the presence 

 in the membrane of an enzyme which has a proteolytic 

 action within the body, resulting in the formation of 

 poisonous albumoses. According to this view the actually 

 toxic bodies are not the direct product of the bacillus, but 

 are formed by the enzyme which is produced by it locally 



