AND OF EXPOSED MUCOUS MEMBRANES. 665 



Steffeck (1892) has examined the vaginal secretion of twenty-nine 

 pregnant females who had not been subjected to digital examina- 

 tion, and found Staphylococcus pyogenes albus in nine, Staphylo- 

 coccus pyogenes aureus in three, and Streptococcus pyogenes in one. 

 These results indicate that puerperal septicaemia from self-infection 

 may occur in exceptional cases. In seventeen of the twenty-nine 

 cases examined none of these pyogenic micrococci were found. 



Hofmeister (1894) has shown that bacteria are found not only 

 upon the mucous membrane of the meatus urinarius in man, but 

 that they may usually be obtained from the urethral canal at a depth 

 of eight centimetres or more, although the number rapidly diminishes 

 in the deeper portion of the urethra. 



Walthard (1895) arrives at the conclusion that while in pregnant 

 females bacteria are constantly found in the vagina and the lower 

 portion of the cervical canal, they are absent from the upper part of 

 the cervical canal, the uterus, and the tubes; and that during the 

 puerperal condition the uterine cavity is preserved from spontaneous 

 infection per vias naturalis by the plug of mucus in the cervical 

 canal. In the vaginal secretions of one hundred pregnant women, 

 who had not been subjected to a digital examination, streptococci 

 were obtained twenty-seven times in cultures. These were not viru- 

 lent, but, according to Walthard, these saprophytic streptococci be- 

 come virulent when, owing to a diminished resisting power, they are 

 enabled to invade the tissues as parasites. 



Kronig (1894) concludes from his investigations that the vaginal 

 secretions of pregnant women are usually so acid that Streptococcus 

 pyogenes could not multiply in them ; also that when the secretion is 

 normal it is almost always sterile. 



Doderlein (1894) insists that the failure of Kronig to obtain micro- 

 organisms in his cultures was due to the fact that suitable media 

 were not used ; also that certain bacilli are constantly found in nor- 

 mal, acid vaginal secretions, and that in the pathological secretions 

 which are feebly acid, neutral, or in some cases slightly alkaline a 

 great variety of bacteria are found, including Streptococcus pyo- 

 genes, as demonstrated by himself and other investigators. In a 

 later paper (1894) Kronig reports his success in obtaining cultures 

 from normal, acid vaginal secretions by using acid media and by 

 cultivating under anaerobic conditions. He reports also that patho- 

 genic bacteria (streptococci, staphylococci, and Bacillus pyocyaneus) 

 introduced into the vaginae of pregnant women lose their power of 

 reproduction in from six to forty-eight hours (streptococci did not 

 grow after six hours). In a still later communication (1894) Kronig 

 reports that the bacteria present in the vaginal secretions of pregnant 



46 



