SUPPURATION AND SEPTIC DISEASES 133 



the cultures are sterilised by heating to 65 C. Injection 

 is followed by a marked temperature reaction. The 

 treatment appears to be more successful in sarcoma than 

 in carcinoma. 



Streptococcus Puerperalis. 



While puerperal fever may be caused by B. coli and 

 Staphylococcus pyogenes aureus, in most cases it is a 

 streptococcus infection, and this is popularly supposed 

 to be S. pyogenes. While this may be the case, a strepto- 

 coccus found in the uterine discharge and in any secondary 

 pus, pleuritic fluid, or sputum by Mackey and Furneau 

 Jordan is considered by them to be probably the most 

 frequent cause. S. puerperalis grows freely upon agar, 

 producing opaque colonies which are much larger than 

 any other streptococci, producing chains of moderate 

 length. It produces acid and clot in milk, acid in lactose, 

 glucose, saccharose, and salicin, but no change in raffinosc, 

 mannite, and inulin. Furneau Jordan suggests that this 

 streptococcus, like 8. fcpcalis, is present in the contents 

 of the bowel, and that the puerperal woman is very 

 susceptible to its action. 



Diplococcus Rheumaticus. 



Poyriton and Paine's organism is usually a diplococcus 

 measuring 0*5 ^ in diameter, but forms masses on solid, 

 and chains in liquid, media. It stains feebly by Gram, 

 grows slowly on gelatin without liquefaction, and forms 

 in broth a flocculent deposit with clear supernatant 

 fluid. On agar it forms minute, white, discrete, slightly 

 opaque colonies, on potato hardly grows, and in litmus- 

 milk forms much acid and a firm clot. It is found in 

 the arthritic and valvular lesions in rheumatic fever, and 

 on inoculation into rabbits may produce arthritis and 

 endocarditis. Poynton and Paine's organism has been 

 found in affected tonsils in the tonsillitis preceding 

 rheumatic fever (Pybus). 



Varieties of Streptococci. 



Attempts at classification have hitherto proved unsatis- 

 factory. Lingelsheim attempted a distinction between 

 the long-chain (S. longus) and short-chain (S. brevis) 

 streptococci, the former being considered more virulent 



