BIOCHEMICAL FEATURES 87 



was that described by Morse 931 in 1898, in which purpura accom- 

 panied a general pneumococcal infection in a twelve-month-old girl. 



A case somewhat similar to Claude's was reported in 1914 by 

 Rolland and Buc. 1154 The patient was an infant dying of a pneu- 

 mococcal meningitis without lung involvement. Necropsy revealed 

 intense visceral purpura, and cultures taken post mortem from the 

 meningeal pus and from serous fluid in the purpuric lesions } 7 ielded 

 pneumococci identical with a strain isolated from the blood during 

 life. Reh 1123 described the case of an infant with bluish-red dis- 

 coloration of the right side, left elbow, and the four extremities. 

 Bacteriological tests showed that the infection was caused by 

 pneumococci. 



Purpura, therefore, is an occasional concomitant of pneumo- 

 coccal infections, and the three cases cited are sufficient to illus- 

 trate the similarity between this change in the blood with the ac- 

 companying capillary permeability and the hemotoxic effects of 

 Pneumococcus. The experimental facts are more pertinent to the 

 present discussion. 



In 1899, Carnot 199 observed the development of a teinte violacee 

 in the nose and ears of a rabbit injected with a pneumococcal 

 "toxin." No details of the preparation of the toxin were given but 

 Carnot stated that it was sterile. It is probable that he employed 

 cell-free broth cultures as did Heyrovsky. 644 The latter, by inject- 

 ing culture filtrates into white mice, induced hemorrhagic derma- 

 toses and hemorrhages of the mucous membranes and other tissues. 

 The condition was severe and affected the internal organs as well 

 as the skin. 



Julianelle and Reimann 694 quoted Neill as having observed hem- 

 orrhagic purpura in white mice injected with an extract of Pneu- 

 mococcus. The authors, by injecting extracts of both virulent and 

 avirulent strains into white mice induced a purpuric condition 

 manifested after four to six hours as a dark-blue discoloration of 

 the skin of the feet, tail, ears, snout, and genitals. Unless the 

 amount of extract was large there was no intoxication and the ani- 



