400 PATHOGENIC BACTERIA. 



tinguishable diphtheria bacillus. Frequently no other 

 bacteria are found in the culture-tube. This vegetation 

 continues for a few days, then gradually gives way to 

 another flora of cocci and bacilli, and finally the normal 

 condition is reestablished." 



The Streptococcus pyogenes and Staphylococcus 

 pyogenes aureus and albus are, in many cases, found in 

 association with it, especially when there are very severe 

 lesions of the throat, attended with invasion of the 

 internal organs. 



In a series of 234 cases carefully and statistically studied 

 by Blasi and Russo-Travali, 1 it was found that in 26 cases 

 of pseudomembranous angina due to streptococci, staphy- 

 lococci, colon bacilli, and pneumococci, 2 patients died, 

 the mortality being 3.84 per cent. In 102 cases of pure 

 diphtheria 28 died, a mortality of 27.45 per cent. Seventy- 

 six cases showed diphtheria bacilli and staphylococci; of 

 these, 25, or 32.89 per cent., died. Twenty cases showed 

 the diphtheria bacilli and Streptococcus pyogenes, with 6 

 deaths — 30 per cent. In 7 cases, of which 3, or 43 per 

 cent., were fatal, the diphtheria bacillus was in com- 

 bination with streptococci and pneumococci. The most 

 dangerous forms met were 3 cases, all fatal, in which the 

 diphtheria bacillus was found in combination with the 

 Bacillus coli. 



In 157 cases of diphtheria and scarlatina studied at the 

 Boston City Hospital by Pearce, 2 there were 94 cases of 

 diphtheria, 46 cases of complicated diphtheria (29 with 

 scarlet fever, 11 with measles, and 5 with measles and 

 scarlet fever), and 17 cases of scarlet fever (in 3 of which 

 measles was also present). 



Of the 94 cases of uncomplicated diphtheria, the 

 Klebs-Loffler bacilli were present in the heart's blood in 

 4, twice alone and twice with streptococci. In 9 cases 

 the streptococcus occurred alone ; in 1 case the pneumo- 

 coccus occurred alone. In the liver the bacillus was 



1 Annales de T Inst. Pasteur, 1896, p. 387. 



' Journal of the Boston Society of Medical Sciences, Mar., 1898. 



