226 MODES OF ACTION. 



three weeks and five days after the first inoculation. At the autopsy 

 " the lymphatic glands of the inguinal and axillary regions were 

 found to be enlarged and reddened; the cervical glands were swollen 

 and the thyroid gland was greatly congested. There was a consider- 

 able excess of clear fluid in the peritoneal cavity. Both layers of the 

 peritoneum were reddened, the vessels of the visceral layer being es- 

 pecially injected. The spleen was enlarged to double the average 

 size; it was mottled, and the white follicles were distinctly outlined 

 against the red ground. The liver was dark in color and contained 

 much blood. . . . The kidneys were congested and the cut surface 

 was cloudy. . . . The pericardial sac was distended with clear se- 

 rum. Under the epicardium were many ecchymotic spots. The 

 lungs exhibited areas of intense congestion or actual haemorrhage 

 into the tissues. . . . The histological lesions in this case are identi- 

 cal with those observed by us in connection with the inoculation of 

 the living organisms." 



To what extent non-specific catarrhal inflammations of mucous 

 membranes are caused by the local action of microorganisms has 

 not been determined, but in gonorrhoea the proof is now considered 

 satisfactory that the " gonococcus " of Neisser is the cause of the 

 intense local inflammation and purulent discharge. In this disease 

 the action of the pathogenic microorganism seems to be limited to 

 the tissues invaded by it, as there is no general systemic disturbance 

 indicating the absorption of a toxic ptomaine. 



Chronic catarrhal inflammations appear, in some cases at least, 

 to be kept up by the presence of microorganisms, which are always 

 found in the discharges from inflamed mucous surfaces. 



The influence of microorganisms, and especially of the pus cocci, 

 in preventing the prompt healing of wounds, is now well established. 

 An extensive suppurating wound or collection of pus, especially if 

 putrefactive bacteria are present, causes fever and nervous symp 

 toms, due to the absorption of toxic products. More intense general 

 symptoms result from the presence of the streptococcus of pus than 

 from the less pathogenic staphylococci ; this is seen in erysipelatous 

 inflammations and in puerperal metritis due to the presence of this 

 micrococcus. Like the other pus cocci, the Streptococcus pyogenes 

 does not usually invade the blood, but when introduced into the sub- 

 cutaneous tissues it induces a local inflammatory process, with a ten- 

 dency to pus formation, and it invades the neighboring lymph chan- 

 nels, in which the conditions appear to be especially favorable for its 

 multiplication. 



Finally, certain pathogenic bacteria, when introduced into the 

 bodies of susceptible animals, quickly invade the blood and multiply 

 in it. In so doing they necessarily interfere with its physiological 



