1 66 SUPPURATION AND ALLIED CONDITIONS. 



and the emboli thus produced act as the carriers of infection 

 to other organs, and give rise to secondary suppurations. 

 The kidneys, heart -wall, brain, and spleen are most 

 frequently infected in this way. 



Experimental. Occasionally ulcerative endocarditis is 

 produced by the simple intravenous injection of staphylococci 

 and streptococci into the circulation, but this is a very rare 

 occurrence. It often follows, however, when the valves 

 have been previously injured. Orth and Wyssokowitsch 

 at a comparatively early date produced the condition by 

 damaging the aortic cusps by a glass rod introduced through 

 the carotid, and afterwards injecting staphylococci into the 

 circulation. Similar experiments have since been repeated 

 with streptococci, pneumococci and other organisms, with 

 like result. Ribbert found that if a potato culture of the 

 staphylococcus aureus were rubbed down so as to form an 

 emulsion in salt solution, and then injected into the circula- 

 tion, some minute fragments became arrested at the attach- 

 ment of the chordae tendineae and produced an ulcerative 

 endocarditis. 



Acute Suppurative Periostitis and Osteomyelitis. 

 Special mention is made of this condition on account of 

 its comparative frequency and gravity. Becker in 1883 

 described a coccus which he believed to be the special 

 organism concerned in this disease, but it has been since 

 completely proved that this organism is simply the staphylo- 

 coccus pyogenes aureus. The great majority of cases are 

 caused by the pyogenic cocci, of which one or two varieties 

 may be present, the staphylococcus, however, occurring 

 most frequently. Pneumococci have been found alone in 

 some cases, and in a few cases following typhoid fever, 

 apparently well authenticated, the typhoid bacillus has been 

 found alone. In others again the bacillus coli communis 

 is present. 



The affection of the periosteum or interior of the bones 

 by these organisms, which is specially common in young 

 subjects, may take place in the course of other affections 

 produced by these organisms or in the course of infective 



