296 CLINICAL BACTERIOLOGY. 



The permanent forms penetrate the intact mucous mem- 

 brane of the. alveoli, and gain entrance into the lymphatics 

 and blood-vessels, in which they germinate. After inhala- 

 tion of anthrax-bacilli, .however, such migration does not 

 take place. The bacilli remain inactive, and cause only 

 local irritation circumscribed inflammation of the lungs. 

 In this connection it may be noted that in quite rare cases 

 of anthrax the disease has also in human beings pursued 

 the clinical course of septicemia^that is, without local in- 

 fection and without malignant pustule. The portal of 

 infection remained undiscovered in these cases, although it 

 is possible that this part was taken by the lungs. 



Distribution of Anthrax-bacilli in the Infected Body. 

 In cases of general infection with anthrax the bacilli are 

 found in the blood, and in only a small number of instances 

 in the larger vessels, the greater amount being present in the 

 capillary area. The capillaries of all the organs, especially 

 the spleen and the liver, are filled by the bacilli, sometimes 

 actually packed with them, so that their lumen appears to 

 be occluded. Most of the bacilli lie with their long axes 

 parallel to the walls of the vessel that is, they are directed 

 in the course of the blood-stream. In the glomeruli of the 

 kidneys and in the intestinal villi the mass of bacteria fre- 

 quently induces capillary hemorrhages. The microorgan- 

 isms in this way gain entrance into the uriniferous tubules, 

 although generally they do not progress beyond the con- 

 voluted tubes (Koch). Anthrax in animals may, therefore, 

 be considered as the type or paradigm of a true infection, the 

 factor of intoxication remaining entirely in the background 

 and the most prominent feature being the enormous multi- 

 plication of the exciting agents. On examining the viscera 

 of animals dead of anthrax the impression is gained that 

 death has resulted from a flooding of the capillary area with 

 the bacilli. The anthrax-bacilli are, however, by no means 

 found in the blood immediately after infection, but several 

 hours always elapse before they appear. The animal, how- 

 ever, will previously have been sick. This indicates that the 

 formation of toxin on the part of the bacteria is not en- 

 tirely wanting a circumstance whose certainty is estab- 

 lished by the course of the disease in less susceptible ani- 

 mals (and in human beings), in which the lesion remains 

 localized. 



In cases of malignant pustule the bacilli are present in 



