54
On referring to the above-mentioned tables it will be seen that in every instanc
e - e x c e p t o n e , i n w h i c h c u l t i v a t i o n s w e r e m a d e f r o m t h e s i t e o f q u i n i n e i n j e c t i o n s i n
the circumstances mentioned, tetanus bacilli were recovered. Vincent 17 in 1904
recorded similar results in some cases of experimental tetanus in guinea pigs in
which quinine had been given hypodermically. It is therefore obvious from the
results recorded in this paper, and from those recorded by Vincent, that the
transference of tetanus micro-organisms from the original site of infection to the
site of quinine injection is one of the results to be expected when quinine is given
hypodermically in tetanus infections ; it is also a possible result to be expected in
latent spore infections. We know that tetanus spores are to be found in the intesti
- n a l t r a c t s o f a l a r g e p e r c e n t a g e o f m a n k i n d , a n d i n s o m e a n i m a l s ; w o u l d a s i m i l a r
transference of infection take place from the intestinal tract in some of these cases
when quinine is given hypodermically ?
In one of the experiments recorded in this series a transference of infection
from the intestinal tract is the only reasonable explanation which can be given to
account for the bacilli isolated from the site of quinine injections.
Four healthy guinea pigs were each given ¾ grain quinine hypodermically on the
front of the chest, and after an interval of two days the dose was repeated. Two days
after the second dose the animals were killed with chloroform, and anærobic cul
- t i v a t i o n s m a d e f r o m t h e s i t e o f t h e q u i n i n e i n j e c t i o n s . A p u r e g r o w t h o f t e t a n u s
bacilli was obtained from one of these cases, but the other three gave negative re
- s u l t s . T h e t e t a n u s b a c i l l i i s o l a t e d f r o m t h i s o n e c a s e w e r e e x t r e m e l y v i r u l e n t f o r
guinea pigs ; 0.1 c.c. of a six clays' growth was sufficient to produce tetanus in a
guinea pig after 12 hours, and death after 24 hours. None of the strains used for
the experiments recorded in this paper was anything like so virulent as this.
The question is, what was the source of infection in this case ?
Before the animal was chloroformed it showed no symptoms of tetanus ; but
this does not exclude the possibility of tetanus setting in later if it had been allowed
to live longer. The fact of tetanus bacilli being absent from the site of quinine
injections in the other three experiments would exclude the quinine as a source of
infection, as all four guinea pigs were inoculated from the same quinine tabloid
and at the same time, and with the same syringe. On each occasion on which
quinine was injected a 5-grain tabloid was dissolved in 5 c.c. of sterile normal saline
solution, and from this solution 3 c.c. were filled into a 3 c.c. syringe, and from this
syringe each guinea pig received c.c.
In these circumstances the only reasonable source of infection in this case was
the animal's own intestinal tract. It is to be regretted that cultivations were not
made from the intestinal tracts of these four animals ; on this account it was de
-cided to repeat the series, and include intestinal cultivations in addition to cultiva
- t i o n s f r o m t h e s e a t o f q u i n i n e i n j e c t i o n s . ( S e e T a b l e X V I I . )