THE TOXIC FACTORS IN EXERIMENTAL TRAUMATIC SHOCK. VI. THE TOXIC INFLUENCE OF THE BACTERIAL FLORA, PARTICULARLY CLOSTRIDIUM WELCHII, IN EXUDATES OF ISCHEMIC MUSCLE.

As has been shown in previous reports from this laboratory (10, 25, 75), toxic effects resembling traumatic shock have been observed following the intravenous injection of fluids exuding from-dog muscles after prolonged ischemia. The fact that 28 per cent of these fluids were highly toxic, whereas the remainder seemed harmless, strongly suggested that their toxic effects were not due to the presence of intracellular substances lost as the result of cell damage (70). For the same reason, it appeared doubtful that the occasional toxic effects were caused by breakdown products of muscle cell constituents resulting from ischemia, since the experimental conditions were all approximately identical. Attention has been directed, therefore, to the one constituent of these fluids which was obviously highly variable, namely, the bacterial flora. Another bit of indirect evidence pointed in this direction. On several occasions, dog muscle tissue was excised and minced with sterile precautions and incubated in sterile dog plasma at 370 C., for 5 hours. The plasma was then separated by centrifugation and injected intravenously into recipient dogs. Such material was invariably toxic, rapidly producing a shock-like state and death, and it was always infected with micro-organisms which on direct smear were seen to be large gram-positive rods. However, if a mixture of blended dog muscle and plasma were sterilized by passage through a Seitz filter before incubation,