is communicated at will to animals. But here the question arose, How do these bacilli produce anthrax? — and in answer to this question various theories were proposed. Recently Honk has given us the true answer by obtaining from pure cultures of the bacillus anthracis a ptomaine which, when injected under the skin of animals, produces the symptoms of the disease, followed by death. The anthrax ptomaine causes at first increased respiration and action of the heart, then the respirations become deep, slow, and irregular. The tem- perature falls below the normal. The pupils are dilated, and a bloody diarrhoea sets in. On section, the heart is found contracted, the blood dark, and ecchymoses were observed on the pericardium and peri- tonaeum. <Callout type="important" title="Important">Understanding these symptoms can help identify anthrax early.</Callout> Cholera. Although the ptomaine of cholera has not been isolated, there are reasons for believing that the comma bacillus of Koch is one of the most active, chemically, of all known pathogenic micro-organisms. In the first place Bitter has shown that this germ produces in meat- peptone cultures a peptonizing ferment, which remains active after the organism has been destroyed. It was shown that this ferment, like sim- ilar chemical ferments, would convert an indefinite amount of gelatine or coagulated albumen into peptone. It was also demonstrated that this REPORT OF COMMITTEE ON DISINFECTANTS. 203 ferment was more active in alkaline than in acid solutions, thus proving* that it resembles pancreatine more than pepsine. This resemblance to pancreatine was further demonstrated by the fact that certain chemicals, such as sodium carbonate and sodium salicylate increased its activity. That a diastatic ferment is also produced by the growth of this bacillus was indicated by the development of an acid in nutrient solutions con- taining starch paste. However, all attempts to isolate the diastatic fer- ment were unsuccessful. A temperature of 6o° destroys or greatly decreases the activity of ptyaline, and this seems to be also true of the diastatic ferment produced by the comma bacillus. But the formation of an acid from the starch presupposes that the starch is first converted into a soluble form. [It is proper to mention here that Sternberg, independently of the experiments of Bitter, has shown that a number of micro-organisms are capable of producing a peptonizing ferment which remains active after destroying the germs by raising the temperature of the culture to 8o°. Sternberg experimented with bacillus prodigiosus, b. indicus, b. pyocy- anus, and Finkler-Prior's spirillum. It is probable that all germs which liquefv gelatine do so by the production of this ferment.] In order to investigate the digestive action of bacteria, Rietsch precip- itated peptone cultures of the chdlera bacillus, typhoid bacillus, bacillus of consumption, and staphylococcus aureus with alcohol, collected, washed, dried, and weighed the precipitates, and tested their action upon coagulated fibrin. The powders thus obtained from cultures of the typhoid and consumption bacillus had no digestive action in either neutral or alkaline fluids. On the other hand, the precipitates obtained from the cultures of the cholera bacillus and the staphylococcus aureus, the latter less energetically than the former, dissolved the fibrine, and the solutions gave reactions for peptones. Rietsch believes that the destructive changes observed in the intestines in cholera are due to the action of this peptonizing ferment. Cantani injected sterilized cultures of the comma bacillus into the peritonael cavities of small dogs, and observed, after from one quarter to one half hour, the following symptoms: great weakness, tremor of the muscles, drooping of the head, prostration, convulsive contractions of the posterior extremities, repeated vomiting, and cold head and extrem- ities. After two hours these symptoms began to abate, and after twenty- four hours the recovery seemed complete. Control experiments with the same amounts of uninfected beef tea were made. These cultures were three days old when sterilized. Older cultures seemed less poisonous, and a high or prolonged heat in sterilization decreased the toxicity of the fluid. From these facts Cantani concludes that the poisonous principle is volatile. The cultures in bouillon containing peptone were more poisonous than those in the simple bouillon. <Callout type="risk" title="Risk">Sterilizing older cultures may not be sufficient to prevent poisoning.</Callout> Klebs has attempted to answer experimentally the question, In what way does the cholera germ prove harmful? Cultures of the bacillus in fish preparations were acidified, filtered, the filtrate evaporated on the 204 REPORT OF COMMITTEE ON DISINFECTANTS. water-bath, the residue taken up with alcohol, and precipitated with platinum chloride. The platinum was removed with hydrogen sulphide, and the crystalline residue obtained on evaporation was dissolved in water and intravenously injected into rabbits. Muscular contractions were induced. Death followed in one animal, which in addition to the above treatment received an injection of a non-sterilized culture. In this case there was observed an extensive calcification of the epithelium of the uriniferous tubules. Klebs believes this change in the kidney to be induced by the chemical poison, and from this standpoint he explains the symptoms of cholera as follows: The cycmosis is a consequence of arterial contraction, the first effect of the poison. The muscular con- tractions also result from the action of the poison. The serous exudate into the intestines follows upon epithelial necrosis. Anuria and the subsequent severe symptoms appear when the formation and absorption of the poison become greatest. Hueppe states that the severe symptoms of cholera can be explained only on the supposition that the bacilli produce a chemical poison, and that this poison resembles muscarine in its action. Bujwid found that on the addition of from five to ten per cent, of hydro- chloric acid to bouillon cultures of the cholera bacillus, there was devel- oped after a few minutes a rose-violet coloration which increased during the next half hour, and in a bright light showed a brownish shade. The coloration is more marked if the culture is kept at about 370. In impure cultures this reaction does not occur. The Finkler-Prior comma bacil- lus cultures give after a longer time a similar, but more of a brownish, coloration. Cultures of many other bacilli were tried, and failed to give the reaction. <Callout type="tip" title="Tip">Adding acid can help detect cholera bacteria in cultures.</Callout> Tetanus. In 1884, Nicolaier, by inoculating 140 animals with earth taken from different places produced symptoms of tetanus in 69 of them. In the pus which formed at the point of inoculation he found micrococci -and bacilli. Among the latter was one which was somewhat longer and slightly thicker than the bacillus of mouse-septicaemia. In the subcuta- neous cellular tissue he found this bacillus alone, but could not detect it in the blood, muscles, or nerves. Heating the soil for an hour rendered the inoculation with it harmless. In culture, Nicolaier was unable to separate this bacillus from other germs, but inoculations with mixed cultures produced tetanus. In the same year Carle and Ratone induced tetanus in lower animals by inoculations with matter taken from a pus- tule on a man just dead from tetanus. In 18S6 Rosenbach made suc- cessful inoculations on animals with matter taken from a man who had died from tetanus consequent upon gangrene from frozen feet. With bits of skin taken from near the line of demarcation he inoculated two Guinea pigs on the thigh. Tetanic symptoms set in within twelve hours, and one animal died within eighteen and the other within twenty-four hours. The symptoms corresponded exactly with those observed in the earth tetanus of Nicolaier, and the same bacillus was found. With mixed cultures of this Rosenbach was also able to cause death by tetanus in animals. Beumer had under observation a man who died from lock- jaw following the sticking of a splinter of wood under his finger-nail. Inoculations of mice and rabbits with some of the dirt found on the wood led to tetanus. The same observer saw a boy die from this disease following an injury to the foot from a sharp piece of stone. White mice inoculated with matter from the wound and those inoculated with dirt taken from the boy's play-ground died of tetanus. The bacillus of Nico- laier was again detected. Giordano reports the case of a man who fell and sustained a complicated fracture of the arm. He remained on the ground for some hours, and when assistance came the muscles and skin were found torn and the wounds filled with dirt. On the fifth day he showed symptoms of tetanus, from which he died on the eighth day. Inoculations and examinations for the bacillus were again successful. Terrari also made successful inoculations with the blood taken during life from a woman with tetanus after an ovariotomy. Hocksinger has confirmed the above-mentioned observations by carefully conducted experiments, the material for which was furnished by a case of tetanus arising from a very slight injury to the hand, the wound being filled with dirt. Finally, Shakespeare has succeeded in inducing tetanus in rabbits by inoculating them with matter taken from the medulla of a horse and of a mule, both of which had died from traumatic tetanus. These uniform observations leave no room to doubt that tetanus is, often at least, due to a germ which exists in many places in the soil, and that the disease is transmissible by inoculation. The question now arises, How do these germs induce tetanus? Brieger has given us an answer, inasmuch as he has obtained in cultures of the germ of Nicolaier and Rosenbach four poisonous substances. The first, tetanine, which rapidly decomposes in acid solutions, but is stable in alkaline solutions, produces tetanus in mice when injected in quantities of only a few milligrams. The second, tetanotoxin, produces first tremor, then paralysis followed by severe convulsions. The third, to which no name has been given, causes tetanus accompanied by free flow of the saliva and tears. The fourth, spasmotoxin, induces heavy clonic and tonic convulsions. It may be that all these will be found to be modifications or impure forms of the same poison. Brieger states that the exact character and relative amounts of the poisons formed vary with the nutrient in which the germ grows. With this evidence before us we feel justified in saying that the tetanus germ produces its poisonous effects by elaborating one or more ptomaines in the body of the animal into which it has been introduced. Typhoid Fever. In 1880 Eberth discovered a bacillus, which he believed to be the cause of typhoid fever, and this belief has been con- firmed. The fever with its characteristic lesions has been produced in animals by inoculation with the germ. Gaft'ky was the first to inoculate 206 REPORT OF COMMITTEE ON DISINFECTANTS. animals with pure cultures of the bacillus of Eberth, but his results were wholly negative. Frankel and Simmonds produced fatal results, and observed after death enlargement of the spleen, mesenteric glands and intestinal follicles. Moreover, microscopical examination of the spleen showed the same conditions which are found in the spleens of persons dead of typhoid fever. Seitz, using Koch's cholera method of inocu- lation, produced with the typhoid bacillus acute enteritis with ulceration and enlargement of the spleen. Vaughan and Novy, using the germ which they had obtained from drinking-water, produced in a cat vomit- ing, great muscular weakness or prostration, primary depression of tem- perature four degrees below the normal, and secondary elevation of tem- perature three degrees above the normal. Section showed ulceration in both the small intestine and ascending colon. Results of this kind leave no doubt that the bacillus first described by Eberth is the true germ of typhoid fever. In 1885 Brieger obtained from pure cultures of the typhoid bacillus a toxic ptomaine, which produced in Guinea pigs a slight flow of the saliva, frequency of respiration, dilatation of the pupils, profuse diarrhoea, paralysis, and death within from twenty-four to forty-eight hours. Post- mortem examination showed the heart in systole, the lungs hyperaemic, and the intestines contracted and pale. This substance Brieger considers the special poison of typhoid fever, and calls it typhotoxine. However, he obtained with this poison no elevation of temperature. In 1887 Vaughan and Novy obtained from pure cultures of the typhoid bacillus, found in drinking-water, which had been the supply for many persons who had the disease, an extract which, when injected under the skin of cats, caused an elevation in the temperature of from two to four and one half degrees above the normal. In one sick of typhoid fever the bacillus grows and multiplies in the intestines and forms the poison, the absorption of which is followed by the rise in temperature and other symptoms of the disease. The lesions in the intestines are probably due to the bacteria themselves, or possibly to the local irritating effect of the ptomaine. Cholera Infantum. There are many reasons for believing that this disease is sometimes at least due to poisoning by tyrotoxicon. The fact that infants nourished exclusively from the mother's breast are almost wholly exempt from the disease, strengthens this belief. We have already seen how quickly and abundantly this poison appears in milk when the conditions are favorable. Moreover, the symptoms induced by the poison agree with those observed in the disease, and the post- mortem changes are identical. Then cholera infantum is a disease of the summer months, when decomposition in milk goes on most readily. It is most common in cities, and among classes who cannot obtain fresh milk or have not the means necessary to keep it fresh. Moreover, it is often allowed to stand in a foul atmosphere, and all know that milk readily takes up disagreeable odors. Even in the country insufficient attention is given to the care of milk. Cows stand and are milked in filthy barns. The udders are generally not washed before the milking, and the vessels for the milk are frequently not as clean as they should be. There can be no doubt that greater attention to the milk used by infants would result in saving many thousands of lives annually. HOW TO AVOID BEING POISONED WITH PTOMAINES. To one who has read the preceding pages, it will be evident that the only way in which poisoning by ptomaines can be avoided consists in preventing their formation. The majority of poisonous ptomaines are not destroyed at the temperature to which food is raised in cooking. The addition of the most powerful disinfectants, such as mercuric chloride, to solutions of ptomaines does not destroy them. Panum boiled his putrid poison for eleven hours without destroying its virulence, and Brieger uses mercuric chloride in the separation of many of his ptomaines. However, the formation of ptomaines may be prevented by the destruc- tion of the germs which produce them, and the methods of accomplish- ing this have been pointed out in the preceding portions of this report. In exceptional cases, as in milk containing tyrotoxicon, boiling the milk will destroy both the germ and the ptomaine, but boiling does not destroy the active principle of poisonous mussel, nor the poison of typhoid fever. METHODS OF PRACTICAL DISINFECTION. By GEORGE H. ROfi, M. D. The scientific determination of the germicide value of various agents used for purposes of disinfection is so recent that practical methods of applying them have not yet been developed to any great degree. Disin- fection by means of steam has received most attention during the last two years, and a number of apparatuses have been devised for the efficient and economical application of this agent. As a supplement to the paper by the writer in the last annual report of the Committee on Disinfec- tants, a description of some of these devices will be given in the following pages. By referring to the report of the committee for 1886 it will be seen that the most efficient devices for disinfection by heat consist of those in which steam under pressure, or passing through the articles to be disinfected in a free current (stromender Wasserdampf), are employed. The opinion was expressed, based upon practical experience, that steam under pressure, in order to raise its temperature (or possibly to increase its penetrating power), was the best form in which to employ the agent. This opinion was justified by European experience, and especially by the personal observations of Drs. S. H. Durgin and Joseph Holt, mem- bers of the committee, to whose reports attention is directed {vide supra et infra) . Recent experience abroad seems to indicate, however, that an appara- tus in which the steam is not confined under pressure may be equally efficient, more easily managed, and much more economical. The simple disinfecting stove of Gibier {vide Report for 18S6), as well as the disinfector of Henneberg {vide infra}, seem to meet all the require- ments of an efficient, economical, and safe disinfecting apparatus. During the recent epidemic of sweating sickness in France, Gibier's stove is said to have been used for purposes of disinfecting clothing and bed- ding with entire success. For small communities, or for county and township health authorities, either of the two apparatuses above mentioned, or a modification of them, would seem to best subserve the requirements of an efficient apparatus. A disinfecting stove large enough to disinfect the furnishings of an ordinary sized bed should not cost more than one hundred dollars. If made in sections like Gibier's stove, it could be transported in any sort of vehicle, and, if necessary, used in the infected room itself. By a little ingenuity the wagon upon which the apparatus is transported might be made to serve as the disinfecting chamber. REPORT OF COMMITTEE ON DISINFECTANTS. 209 The temperature in the interior of the chamber should be maintained at ioo°C. (2120 F.), or above for ten to fifteen minutes in order to make sure of the destruction of all infectious material. Every apparatus should be tested for its disinfecting power before being placed in actual service.
Key Takeaways
- Bacteria produce toxic substances called ptomaines that can cause severe diseases like cholera and tetanus.
- Understanding the symptoms of these diseases can help in early identification and treatment.
- Proper disinfection methods, such as steam sterilization, are crucial to prevent the spread of infectious material.
Practical Tips
- Regularly test and maintain any disinfection equipment to ensure it is functioning properly and effectively.
- Boiling milk for at least ten minutes can help eliminate harmful bacteria and toxins in milk, protecting infants from diseases like cholera infantum.
- Use steam sterilization methods when available, as they are effective against a wide range of pathogens.
Warnings & Risks
- Do not rely solely on boiling to disinfect all types of infectious material; some toxins may survive boiling temperatures.
- Be cautious with the handling and disposal of cultures containing toxic substances to avoid accidental exposure or contamination.
- Always test new disinfection methods before applying them in a real-world scenario, as their effectiveness can vary.
Modern Application
While the specific techniques described in this chapter are outdated, the principles of identifying and eliminating harmful bacteria through proper sanitation and sterilization remain