Abstract
A detailed discussion followed of the interrelationship between bioassay of endotoxin and clinical manifestation of disease. Several investigators indicated that, in agreement with data presented during the formal session, they were unable to relate shock and death to the presence or absence of a positive test for endotoxinlike materials by any of the several tests now available. Some investigators did not find that as many as 45%-50% of patients with positive blood cultures gave positive responses to the Limulus assay; others pointed out that even when such positive responses are found, they have relatively uncertain predictive value. There was an extended discussion of the role of intestinal bacteria in releasing the substances found in the blood stream when there is a positive response by the skin test or the Limulus assay, and it was generally agreed that the present evidence favored the intestinal source of the materials. It
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