Pathogenesis 465 



alone and twice with streptococci. In 9 cases the strepto- 

 coccus occurred alone ; in i case the pneumococcus occurred 

 alone. In the liver the bacillus was found in 24 cases, 

 alone in 1 2 and together with the streptococcus in 12; the 

 streptococcus occurred in 27 cases, alone in 14, with the 

 Klebs-Loffler bacillus in 12, and with Staphylococcus 

 pyogenes aureus in i. Staphylococcus pyogenes aureus 

 occurred in 4 cases, alone in 3 and associated with the 

 streptococcus in i. The pneumococcus occurred alone in 

 i case. 



In the spleen the Klebs-Loffler bacillus occurred eighteen 

 times, fifteen times alone and three times associated with 

 the streptococcus. The streptococcus occurred in 24 cases, 

 alone in 21, associated with the Klebs-Loffler bacillus twice, 

 and with Staphylococcus pyogenes aureus once. Staphy- 

 lococcus pyogenes occurred twice, once alone and once with 

 the streptococcus. The pneumococcus occurred twice alone. 



In the kidney the Klebs-Loffler bacillus occurred in 23 

 cases, in 15 alone, in 5 associated with the streptococcus, 

 and in 2 with Staphylococcus pyogenes aureus. The 

 streptococcus occurred in 26 cases, in 19 of which it was the 

 only organism present. Staphylococcus pyogenes aureus 

 occurred in 8 cases, in 4 of which it was in pure culture. 

 The pneumococcus occurred four times, three times in pure 

 culture and once with the Klebs-Loffler bacillus. 



In the 46 cases of complicated diphtheria, the heart's 

 blood showed pure cultures of the streptococcus nine times 

 and the streptococcus associated with the Klebs-Loffler 

 bacillus once. The diphtheria bacillus occurred alone once. 



In the liver, in 10 cases streptococcus occurred alone, in 

 7 cases associated with the Klebs-Loffler bacillus, and in 3 

 cases with Staphylococcus pyogenes aureus. The diphtheria 

 bacillus occurred in pure culture in 5 cases. 



The spleen contained streptococci only thirteen times and 

 mixed with the diphtheria bacillus twice. The diphtheria 

 bacillus was found in pure culture in 5 cases. 



The kidney contained pure cultures of streptococci in 

 10 cases, streptococci associated with diphtheria bacilli five 

 times, and with Staphylococcus pyogenes aureus three 

 times. The diphtheria bacillus occurred alone in 7 cases. 

 Staphylococcus pyogenes aureus and the pneumococcus 

 each alone once and both together once. 



"The clinical significance of this general infection with the 

 30 



