408 THE QUESTION OF IMMUNITY AND ANTITOXINS 



whole of this compound process may be tabulated roughly as 

 follows : — * 



Bacillus coli. 

 Staphylococci. 

 Diplococci. 

 Streptococci. 



Toxins. 



Suppurative glands, 

 septic poisoning, 

 etc. 



Bacillus of diphtheria = primary infective agent. 



Inflammatory changes and fibrinous exudation. 



Ferment in membrane = secondary infective agent. 



Passes through body, and ) 

 by digestion of proteids ^^^^"^^^ i 

 produces . . .( AN organic acid. 



1. Fever. 



2. Diarrhoea. 



3. Loss of body weight. 



4. Fatty degeneration. 



5. Degeneration of peri- 



■pneral nerves and 

 resulting paralysis. 



Such is the specific effect of toxins in diphtheria. The same 

 principles apply with equal force in tetanus, typhoid, etc., the 

 differences being in degree of virulence, specificity, mode of onset, 

 and portions of the body affected. 



Sidney Martin suggested a provisional classification of bacterial 

 toxins as follows : — f 



1. Poisons secreted by the bacterium itself = (ferment F^j 



toxin ?) I = Extracellular 



2. Products of digestive action of bacterium = albumoses; j bacterial poisons. 



3. Final non-proteid products = animal alkaloid ; J 



4. Poisons present in the body of the bacillus { b= 4riS pSs. 

 Such occur, for example, in the tubercle bacillus and the cholera vibrio. 



The toxins of bacteria are of a kind which cannot be fully 

 expressed chemically, but only pathologically. They are probably 

 of a ferment nature in diphtheria and tetanus. The arguments in 

 support of that view are — (1) that they act in infinitesimal doses ; 

 (2) that they may act slowly and produce death after many days by 

 profoundly affecting the general nutrition; and (3) that they are 

 sensitive to the action of heat in a way that no chemical poisons are 

 known to be. If they are considered as ferments, they must be 



* It should be distinctly understood that this table is merely schematic and 

 provisional. The details of toxin production and -its effect are of course still open 

 to revision and amendment. 



t Sidney Martin, M.D., F.R.S., F.R.C.P., Croonian Lectures delivered before the 

 lioyal College of Physicians, June 1898. 



