BACTERIA IN INFECTIOUS DISEASES. 601 



it in some particulars. The same bacteriologists found the pneu- 

 monia coccus in two cases in children. Fisher and Levy (1893) also 

 report two cases, in children, in which this micrococcus was found 

 one a fatal case of meningitis. In two other cases streptococcus 

 pyogenes was obtained in pure cultures. The typhoid bacillus has 

 also been found by several investigators Ebermayer, Orion , Colzi, 

 Ullmann. It is therefore evident that osteomyelitis cannot be con- 

 sidered a specific affection; on the other hand, as in abscesses de- 

 veloped in the cellular tissue, in glands, or in the various organs, it 

 is to be regarded as a localized infectious process which may be 

 induced by various pathogenic microorganisms which through some 

 channel have effected a lodgment in the blood or tissues of the body. 

 The exciting cause of a peri osteal inflammation is, no doubt, not in- 

 frequently an injury of some kind. Chronic periostitis and osteo- 

 myelitis are developed in a similar way as a result of a localized 

 tubercular infection. 



OTITIS MEDIA. 



In otitis media various microorganisms have been found in pus 

 obtained by paracentesis of the tympanum, as well as in the chronic 

 discharge after perforation ; and there can be but little doubt that 

 these microorganisms are responsible, directly or indirectly, for the 

 inflammatory process and pus formation. The following species are 

 most frequently found in the purulent discharge in recent cases of 

 otitis media : Micrococcus pneumonia crouposa3 (" Diplococcus pneu- 

 moniaa "), Streptococcus pyogenes, Staphylococcus pyogenes albus, 

 Staphylococcus pyogenes aureus, Friedlander's bacillus. The fol- 

 lowing have also been found occasionally: Staphylococcus tenuis, 

 Bacillus tenuis, Micrococcus tetragenus, Bacillus pyocyaneus. 



According to Zaufal, Micrococcus pneumonia crouposa3 is most 

 frequently found in cases which result from exposure to cold, while 

 the ordinary pus cocci are more frequently found in otitis which is 

 secondary to specific febrile diseases. 



Martha (1892) reports two cases in which Bacillus pyocyaneus 

 was present in pure culture in fifty-one other cases examined this 

 bacillus was not found. This bacillus has also been found occasion- 

 ally by other investigators Pes and Gradenigo (1894), Hartmann 

 (1894), Kossel (1894). 



Scheibe (1892) in sixteen cases of mastoid abscess following mid- 

 dle-ear disease found the micrococcus of pneumonia in six, Strepto- 

 coccus pyogenes in five, Staphylococci in one, and an undetermined 

 micrococcus in one. 



Stern (1895) in thirty cases of chronic purulent otitis media made 

 bacteriological examinations with the following result : Staphylococ- 

 42 



