BOTULISM: DEMONSTRATION OF TOXIN IN BLOOD AND TISSUES

The diagnosis of botulism is often difficult when the disease occurs in isolated instances. It is made largely on the history and the physical examination, confirmed whenever possible by the demonstration of the organism or toxin in the source of poisoning. In fatal cases even necropsy gives little pathognomonic evidence of this disease, although Schwarz¹ has recently called attention to certain histologic appearances in the central nervous system which he thinks may be specific of botulism. The demonstration of toxin in the blood or tissues in suspected cases, apart from the demonstration of Clostridium botulinum, should be of value in the diagnosis of the disease but as far as can be determined has not been successfully accomplished in this country.

It is generally believed that the amount of botulinus toxin necessary to produce symptoms in the patient is so minute as to preclude its detection in the blood. However,