266 SPECIFIC MICRO-ORGANISMS 



by heating to 80 C. Other soluble poisons seem also to be pre- 

 sent. The bacterial cells killed by heat are only slightly toxic, 

 yet it is very probable that in the disintegration of the cocci in 

 an inflammatory process more poisonous substances may be 

 derived from their cell protein. 



Rabbits are the animals of choice for inoculation with staphy- 

 lococci. Intravenous injection with virulent cultures usually 

 causes multiple abscesses in the internal organs with death in 

 4 to 8 days. Typical endocarditis has been produced by injected 

 organisms from potato cultures, and with greater certainty when 

 the heart valves are injured mechanically, especially in young 

 rabbits. Osteomyelitis sometimes follows intravenous injection 

 in growing rabbits, especially if the bone be slightly injured 

 at the time of inoculation. In man, typical furuncles and carbun- 

 cles have been produced by rubbing pure cultures on the skin 

 (Garre 1885) and by subcutaneous injection. 



In man this organism is a frequent cause of local purulent 

 inflammations, and it sometimes gives rise to pyemic abscesses 

 and general bacteremia. Recurrent furuncles and carbuncles 

 are ordinarily due to staphylococci. 



Animals have been immunized to staphylococci but the serum 

 obtained from them has relatively slight value in treatment. 

 Specific treatment by means of dead bacterial cells, bacterial 

 vaccines, has been developed by A. E. Wright and has proved 

 its value in the treatment of chronic furunculosis. A suspension 

 in salt solution of bacterial cells from an agar slant, sterilized 

 by heating to 60-65 C. for 30 minutes and standardized by 

 microscopic count of the bacterial cells, is employed. Doses 

 from 50 million to 1000 million bacterial cells are injected two 

 or three times a week for a long period of time, the size and fre- 

 quency of dosage being governed by the clinical condition of the 

 patient. Determination of the opsonic index is probably un- 

 necessary and is now quite generally neglected. Autogenous 

 vaccines (made with the staphylococcus isolated from the patient) 

 are usually superior to stock vaccines. 



