384 TETANUS 



into the sciatic nerve was followed by tetanus. This would 

 appear to militate against Ehrlich's position that antitoxin is 

 manufactured in the cells which are sensitive to the toxin (see 

 Immunity). 



Reference may here be made to the effects of injecting tetanus 

 toxin into the brain itself, as investigated by Roux and Borrel. 

 It was found that the ordinary type of the disease was not 

 produced, but what these observers called "cerebral tetanus." 

 This consisted of general unrest, symptoms of a psychic 

 character (apparent hallucinations, fear, etc.), and epileptiform con- 

 vulsions. Death occurred in from twelve to twenty hours without 

 any true tetanic spasms. In this manifestation of tetanus the 

 incubation period was much shorter than with subcutaneous 

 injection, and the fatal dose was one twenty-fifth of the minimal 

 subcutaneous dose. Further, the injection of antitoxin forty-eight 

 to ninety-six hours previously did not prevent an animal from suc- 

 cumbing to the intracerebral inoculation. In the light of what has 

 been already said these results would seem to indicate a special 

 effect of the toxin when brought into direct contact with the 

 protoplasm of the brain cells. 



We have seen, that unless suitable precautions are adopted, in 

 experimental tetanus in animals death results not from inocula- 

 tion but from an intoxication with toxin previously existent in 

 the fluid in which the bacilli have been growing. According to 

 Vaillard, if spores rendered toxin-free, by being kept for a 

 sufficient time at 80 C., are injected into an animal, death does 

 not take place. It was found, however, that such spores can be 

 rendered pathogenic by injecting along with them such chemicals 

 as lactic acid, by injuring the seat of inoculation so as to cause 

 effusion of blood, by fracturing an adjacent bone, by introducing 

 a mechanical irritant such as soil or a splinter of wood (as in 

 Kitasato's experiments), or by the simultaneous injection of 

 other tjacteria such as the staphylococcus pyogenes aureus. These 

 facts, especially the last, throw great light on the disease as it 

 occurs naturally, for tetanus results especially from wounds 

 which have been accidentally subjected to conditions such as 

 those enumerated. Kitasato now holds that in the natural 

 infection in man, along with tetanus spores, the presence of 

 foreign material or of other bacteria is necessary. Spores alone 

 or tetanus bacilli without spores die in the tissues, and tetanus 

 does not result. 



Immunity against Tetanus. Antitetanic Serum. The arti- 

 ficial immunisation of animals against tetanus has received much 

 attention. The most complete study of the question is found 



