TETANUS. 283

until there is sufficient toxemia to produce spasms, and
that therefore it is impossible to attack the disease in its
inception; we are obliged to meet it upon the same
grounds as diphtheria in the later days of the disease—
a time when it is well known that the chances of im-
provement are greatly lessened.

Of course, as there is no other remedy that combats
the disease at all, the antitoxin is one which, when ob-
tainable, should always be employed.

An interesting observation has been recently made by
Wasserman,1 who, assuming that the destruction of
nerve-cells in the cerebrum and cord during tetanus tox-
emia might have something to do with immunity, be-
lieved it possible to obtain from these cells an immuniz-
ing substance. Investigating the subject, he found that
when fresh brain or spinal cord was rubbed up in a mor-
tar with physiological salt solution, and injected into ani-
mals, the mixture had the power not only to confer upon.
them an immunity lasting for twenty-four hours, but also
was potent enough to neutralize the effects of an injec-
tion of tetanus toxin ten times as large as that necessary
to kill the animal in doses of i c.cm.

These observations may offer a possible solution of the
difficult problem laid before us by Montesano and Mon-
tesson,2 who unexpectedly found the tetanus bacillus in
pure culture in the cerebro-spinal fluid of a case of para-
lytic dementia that died without a tetanic symptom.

1 Berlin, klin. Wochenschrift, 1898, No. I.

2 Centralbl.f. Bakt^ u. Parasitenk., Bd. xxii., Nos. 22, 23, p. 663. Dec., 1897.