MALIGNANT OEDEMA 433 



etc., may, as we have said, in some cases lead to the anticipation 

 that tetanus will probably result. 



(b) Cultivation. The methods to be employed in isolating 

 the tetanus bacilli have already been described (p. 417). It 

 may be added, however, that if the characteristic forms are 

 not seen on microscopic examination of the material from the 

 wound, they may often be found by inoculating a deep tube of 

 one of the glucose media with such material, and incubating for 

 forty-eight hours at 37 C. At the end of this period, spore- 

 bearing tetanus bacilli may be detected microscopically, though 

 of course mixed with other organisms. 



(c) Inoculation. Mice and guinea-pigs are the most suitable 

 animals. Inoculation with the material from a wound should 

 be made subcutaneously. A loopful of the discharge introduced 

 at the root of the tail in a mouse will soon give rise to the 

 characteristic symptoms, if tetanus bacilli are present. With 

 suspicious organisms isolated by culture it is well to use the 

 splinter method (p. 423), as some strains of the b. tetani tend to 

 produce little toxin in artificial media, and may be injected 

 without causing tetanic symptoms. 



MALIGNANT (EDEMA (Septicemie de Pasteur). 



The organism now usually known as the bacillus of malignant 

 cedema is the same as that first discovered by Pasteur and 

 named vibrion septique. He described its characters, distin- 

 guishing it from the anthrax bacillus, which it somewhat 

 resembles morphologically, and also the lesions produced by it. 

 He found that it grew only in anaerobic conditions, but was 

 able to cultivate it merely in an impure state. It was more 

 fully studied by Koch, who called it the bacillus of malignant 

 oedema, and pointed out that the disease produced by it is not 

 really of the nature of a septicsjemia, as immediately after death 

 the blood is practically free from the bacilli. 



" Malignant oedema " in the human subject is usually 

 described as a spreading inflammatory oedema attended with 

 emphysema, and ultimately followed by gangrene of the skin 

 and subjacent parts. In many cases of this nature the bacillus 

 of malignant oedema is present, associated with other organisms 

 which aid its spread, whilst in others it may be absent. One of 

 us has, however, observed a case in which the bacillus was 

 present in pure condition. Here there occurred intense oedema 

 with swelling and induration of the tissues, and the formation 

 of vesicles on the skin. Those changes were attended with a 

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