OCCURRENCE OF CAUSATIVE AGENTS. 163 



and from the pus cultures are made directly, or plates are 

 poured and cover-slip preparations are prepared. 



The excretory products of septic patients urine, sweat, 

 and saliva at times contain the exciting agents of the ex- 

 isting disease, and in suitable cases it is, therefore, advisable 

 to examine these secretions also. The elimination of the 

 bacteria through these channels constitutes a mode by 

 which the organism spontaneously gets rid of the exciting 

 agents of the disease. 



Experiments on Animals. Experimental septicemia, 

 such as may be induced in animals by means of the most 

 varied microorganisms, can not without qualification be 

 considered analogous to septicemia in human beings. In 

 experiments on animals unlimited multiplication of the bac- 

 teria in the blood takes place, although it is to be borne in 

 mind that enormous multiplication sets in only a short 

 time before the death of the animal. The conditions are 

 much simpler in the case of pyemia, as this disorder may 

 be induced in animals through all portals of infection and 

 with all pyogenic microorganisms. It is a necessary con- 

 dition, however, that the microorganisms employed in the 

 experiment shall possess a sufficient degree of virulence. 



PUERPERAL FEV.ER. 



Puerperal fever is only clinically a special form of pyemia 

 or septicemia ; but in relation to its causative agents, analo- 

 gous to all other varieties. The streptococcus pyogenes, 

 the staphylococcus pyogenes, and, less commonly, the 

 bacterium coli have been found to be its exciting agents. 

 The severity of the disorder is dependent upon the fact 

 that the bacteria gain entrance directly into the open lumen 

 of the vessels of the uterine mucous membrane injured in 

 the process of parturition, and by this means into the gen- 

 eral circulation. The process pursues a relatively favor- 

 able course when the vessels are already occluded by 

 thrombi, and the larger lymph-trunks are again closed. 

 The bacteria then wander through the lymph-spaces be- 

 tween the muscle-fibrils, reach the pelvic connective tissue, 

 and there give rise to a localized, circumscribed, suppura- 

 tive process, so-called puerperal parametritis. The occur- 

 rence simultaneously, or in rapid succession, of widely 

 separated foci of suppuration as, for instance, the periton- 



