SPECIFIC DIFFERENCES OF ACTION. IS 



organism and its ferment. Both organisms attack a weakened sur- 

 face or tissue, first locally, the tubercle bacillus acting on the 

 weakened epithelial surface; the septic organism attacking tissues 

 which by bruising or laceration have lost their resisting power. 

 Having once found a coign of vantage, these organisms — though, as 

 seen above, with very different degrees of rapidity — multiply, elaborate 

 ferments, and put to their own use the materials that they obtain from 

 the tissues upon which they are growing. From this point the 

 ferment or product may be absorbed by the lymphatics, and then 

 passed on to the small veins. Here, apparently, the resemblance 

 ceases, though only apparently, for it will be found that in cases of 

 acute tuberculosis, as pointed out by Weigert, there is undoubtedly 

 an invasion of the system by the veins ; whilst in certain cases of 

 more chronic septic poisoning the course is readily followed from the 

 original source through the lymphatics, and so to the veins, where 

 the micro-organisms are lost sight of, but are again detected in the 

 secondary inflammatory foci. The difference between the two mani- 

 festations could be accounted for by the different rapidity of growth of 

 each of the micro-organisms and its ferment; by the relative diffusi- 

 bility and activity of the toxic ferment produced ; and by the resis- 

 tance of the tissues to the action of this ferment, either locally or 

 generally. Although such a parallel may be drawn between acute 

 septic poisoning and the tubercular process, there are, nevertheless, 

 certain facts which do not conform to the rule thus laid down. 

 There may be acute septic intoxication without the presence of 

 a single micro-organism in the tissues. Here there is sufficient 

 of the toxic material, developed on a large exposed surface, from 

 which it is absorbed, to give rise to the death of the patient. 

 The alkaloids formed during the decomposition of animal matter, if 

 carefully separated and injected into a vein, or even into the con- 

 nective tissue, have a similar effect ; and even one of the products of 

 the best known form of fermentation — a fermentation which takes 

 place under well defined conditions, and outside the body — alcohol, 

 has a distinct toxic effect on the nerve centres, if taken in sufficient 

 quantities. This toxic effect, though similar in many respects to that 

 induced during the course of the specific infective diseases, must be 

 carefully distinguished from it. In the true specific diseases organisms 



