96 The Philippine Journal of Science 
coccus; but a complete tonsillectomy appears to be followed in 
most cases by the absence of the streptococcus from the throat. 
Of the complications, empyema is the most common; septi- 
cemia is not uncommon; pericarditis, multiple arthritis, and 
multiple abscesses may occur. Meningeal involvement was dem- 
onstrated in both cases recorded. 
Hamilton and Havens have reported work which they have 
done with this organism and which gives promise. They claim 
to have studied many strains, which could be grouped in a few 
definite types. They report that they have found at least four 
groups, which were fairly distinct. These authors say: 
These groups are obtained by the serological reactions of the different 
strains, since the cultural characteristics have no relation to their immu- 
nological groupings. The serum of rabbits immunized with a strain of 
hemolyticus, protects mice against infection with a homologous strain, but 
not against strains which are serologically different. But certain “Master” 
strains can be isolated, by their serological reactions. 
The suggestion is made that these strains may be used in the 
production of a serum for therapeutic use. 
Certain differences between the hemolytic and nonhemolytic 
strains have been noticed. There is a tendency for the hemo- 
lytic strains to preserve the classical arrangements in chains 
made up of distinct cocci, and not to appear as chains made up 
of diplococci. The power actively to invade the body, exhibited 
by the hemolytic strains, which frequently produces epidemics, 
is not shared by the nonhemolytic strains. 
CONCLUSIONS DRAWN FROM OUR CASES 
1. That the local manifestations in the throat were due to the 
streptococcus hemolyticus. 
2. That there existed a true bacteremia, septiceemia, and 
pyzemia, with primary focus probably in the throat. 
3. That the streptococcus was isolated in pure culture from 
the exudates. 
4, That there was apparent predilection of the streptococcus 
for all serous membranes and the extremely rapid development 
of pus. 
5. That the serum at times appeared to have some beneficial 
results, but by laboratory experimentation with the serum 
against the culture from the patient, it was proven to have no 
serologic reaction. 
6. That the autogenous vaccine was absolutely contra-indi- 
cated, and was only “adding insult to injury.” 
