42 WOUND TREATMExNT 



. Streptococcus pyogenes is another very important or- 

 ganism. It is the causal agent in spreading cellular 

 inflammation, and of pyemia and septicemia in many in- 

 stances; also of septic metritis, and ulcerative endo- 

 carditis. One of its peculiarities is its tendency to invade 

 the lymphatics and to induce lymphangitis and cellulitis ; 

 another is its capability of producing acute suppuration, 

 sloughing of the tissues, and inflammatory wound- 

 gangrene. Probably there are many varieties of Strepto- 

 cocci, but their characters resemble each other so closely 

 that it has not been possible to isolate them. Thus the 

 S. erysipelatis, the causal agent of erysipelas, resem- 

 bles so closely, both in appearance and cultural charac- 

 ters, the S. pyogenes, that many authorities regard them 

 as identical. The effects produced, however, are rather 

 distinctive, and the S. erysipelatis must be regarded as 

 an organism of serious importance in connection with 

 the treatment of wounds. 



The powers of resistance of Streptococci must be re- 

 garded as feeble when compared with those of 

 Staphylococci. 



Bacilli of importance in connection with wound infec- 

 tion are the tetanus bacillus, the hacillus of necrosis, 

 (B. necrophorus), the hacillus of malignant edema, and 

 the hacillus coli communis. Occasionally the hacillus 

 tiiherculosis and the hacillus (Pseudomonas) pyocyaneus 

 may infect wounds. Among other causal agents in 

 wound infection we may mention the Botryomyces and 

 the Actinomyces, also the Streptococcus equi, the causa- 

 tive factor in strangles or colt distemper. 



With such a formidable list of micro-organisms before 

 us, it is apparent that the most important part of our 

 duties in connection with the treatment of wounds is 

 to prevent the entrance of these microbes so far as is 

 possible, or, failing in this, to destroy their vitality or 

 retard or prevent their development. 



