Tetanus. 355 



once. 3rd. The antidotal treatment by phenol and iodine must 

 not be omitted. 4th. Palliative treatment by antispasmodics, nar- 

 cotics or soporifics must go hand in hand with antitoxic treat- 

 ment. 5th. Measures should be taken to secure elimination of 

 the toxins present in the blood. 



Treatment by brain emulsion. Wassermann and Takaki (Ber- 

 lin Klin. Woch. Jan. 3d, 1898) have in a number of cases, 

 mixed i cc. of brain substance of a warm-blooded animal with ten 

 times the lethal dose of tetanus toxin and injected without pro- 

 ducing any symptoms of tetanus. They obtained a similar im- 

 munity by injecting the brain emulsion 24 hours after the injec- 

 tion of three times, and in other cases of five times the lethal 

 dose of tetanus toxin. Control cases uniformly died of tetanus. 

 The brain matter was obtained from Guinea-pigs, pigeons, rab- 

 bits, horses, and men. They accordingly advanced the theory 

 that brain matter is a direct antidote to the tetanus toxin, ufiiting 

 with it chemically and rendering it innocuous. The liver, spleen, 

 kidney, bone marrow and blood serum gave no such protection. 



Marie, in a series of experiments, injected the brain emulsion 

 and tetanus poison at different parts of the body of Guinea-pigs 

 and found that fatal tetanus ensued. It would appear, therefore, 

 that the brain emulsion acts by direct contact, and that it is only 

 by its meeting and combining with the toxin before the latter 

 reaches the spinal cord that tetanus can be prevented. 



Roux and Borrel (.Ann. de I'Instit. Pasteur, 1898) demon- 

 strated this union between the poison and brain matter, by mak- 

 ing an emulsion of the two, and putting in a centrifuge, which 

 will separate the brain substance from the clear liquid. The 

 fluid obtained in this way was shown by injection on the living 

 animal to contain almost no toxin. Knorr and Blumenthal 

 reached the same conclusion as to a chemical union with the 

 brain matter which robbed the toxin of its toxicity. 



Knorr, and Tizzoni, and Cattani and Morax showed indeed, 

 that if the tetanus toxin is injected subdurally or into the surface 

 layers of the cerebrum, it produces not tetanus, but a character- 

 istic cerebral disease. A dose of -^Vth or ji^th cc. of tetanus 

 toxin produces in the rabbit, in 10 to 12 hours, restlessness, con- 

 stant change of place, and signs of great fear like hiding the head, 

 turning rapidly round, attempting to escape, polyuria, grinding 



