The Toxicity of Pneumonic Lungs

Abstract

In lobar pneumonia the toxemia is ascribed largely to toxic substances from virulent pneumococci. Numerous investigations have shown that pneumococci do not produce appreciable amounts of soluble toxin in cultures, although the work of Neufeld and Dold,1 Rosenow2 and Cole3 indicate that a toxic substance is produced from the cocci or contained within them which, when liberated, is capable of producing death in animals with symptoms and lesions suggestive of anaphylaxis. Cole regards this pneumotoxin as preformed in the bacterial cell; the studies of Cohen, Weiss and Kolmer4 generally confirm these observations, although they experienced considerable difficulty in the preparation of the pneumotoxin. While this toxic substance may be elaborated during lobar pneumonia in sufficient amounts to account in large part for the toxic symptoms in addition to probably influencing enzymic processes, our experiments show that its production in vitro is quite irregular, that large numbers of virulent pneumococci are required for its production, and that relatively large amounts of it are required to produce intoxication of animals. When it is remembered that sections of pneumonic lungs frequently show few pneumococci, it is questionable whether there is a sufficient amount of pneumotoxin produced in lobar pneumonia to account in whole for the toxemia of this disease. With these considerations in mind we have studied the exudate in lobar pneumonia as a further source of toxic substances. While the investigations of Schenck,5 Dold,6 Roger,7 Wright,8 and Riesman