Streptococci : their toxins and antitoxins lecture delivered at St. Mary's Hospital, May, 1927 / by R.A. O'Brien.

  • O'Brien, Richard Alfred, 1878-1970.
Date:
[1927?]
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Licence: In copyright

Credit: Streptococci : their toxins and antitoxins lecture delivered at St. Mary's Hospital, May, 1927 / by R.A. O'Brien. Source: Wellcome Collection.

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    conditions, they cause constitutional symptoms. Because streptococci (enterococci, &c.), occur in the bowel in large numbers they cause diarrhoea, &c. Although the title of our prescribed subject deals with the toxins and antitoxins of the streptococci, I may be permitted to refer to the other aspect of streptococcal attack, the so-called “ septic ” manifestations. A hypothesis which we might use for the moment for the sake of clearness is that the S. scarlatince has two modes of attack —the “ toxic ” and the “ septic.” In violent epidemics, it is the early acute toxic attack which kills most patients ; in mild epidemics it is the later “ pyogenic ” or “ septic ” manifestations, in which the living organisms settle down locally in the glands, joints, mastoid, &c., that cause the greatest harm. It is a curious thing that in the Parish-Okell rabbit method, scarlet fever antitoxin gives complete protection against the first “ toxic ” attack of the streptococcus, which is rapidly fatal to unprotected rabbits, but that this antitoxin apparently gives but small or no protection against the development of the later septic lesions in joints, &c. Similarly, it is probable that no scarlet fever antiserum now available has any direct effect on the late septic complications of scarlet fever. It is probable that the solutions of this difficult part of the problem will be found in the investigation of cellular immunity with which the Medical School of St. Marjr’s Hospital has been for so long identified, and that future work may lead to a convergence of the “ cellular ” and “ humoral ” aspects of immunological research of the activities of the streptococci. Summary. The examination of agglutination, toxin and antitoxin relationships of the various “ pathogenic ” streptococci suggests that there is a very close relationship between all the members of the group. The further analysis of this close relationship is the problem before us. The Post-Graduate Medical Journal, No. 1, Bedford-street, Strand, W.C.2.