SUPPURA TION. 193 



years without any particular precautions and found its 

 virulence unchanged. 



Probably the virulence and attenuation are peculiarities 

 of the organism itself. 



Dried streptococci are said by Frosch and Kolle to re- 

 tain their energies longer than those growing on culture- 

 media. 1 



Like the staphylococci, the streptococcus is frequently 

 associated with internal diseases, and has been found in 

 erysipelas, ulcerative endocarditis, periostitis, otitis, men- 

 ingitis, emphysema, pneumonia, lymphangitis, phleg- 

 mons, sepsis, and in the uterus in cases of infective puer- 

 peral endometritis. In man the streptococci occur in the 

 most active forms of suppuration. Its relation to diph- 

 theria is of interest, for, while, in all probability, the 

 great majority of cases of pseudomembranous angina are 

 caused by the Klebs-Loffler bacillus, yet an undoubted 

 number of cases are met with in which, as in Prudden's 

 24 cases, no diphtheria bacilli can be found, but which 

 seem to be caused by a streptococcus exactly resembling 

 that under consideration. 



There is no clinical difference in the picture of the 

 throat-lesion produced by the two organisms, and the 

 only positive method of diagnosticating the one from 

 the other is by means of a careful bacteriologic examina- 

 tion. Such an examination should always be made, as it 

 has much weight in connection with the treatment. Of 

 course, in streptococcus angina no benefit could be ex- 

 pected from the diphtheria antitoxic serum. 



Hirsh 2 has shown that under pathological conditions 

 streptococci are by no means rare organisms in the in- 

 testinal canal of infants, and may cause a streptococcic 

 enteritis. In these cases the organisms are found in large 

 numbers in the stomach and in the stools, and later in 

 the course of the disease in the blood and urine of the 

 living child and in the internal organs of the cadaver. 



1 Fliigge's Die Mikroorganismen. 



2 Centralbl. fur Bakt. ttnd Parasitenk., Bd. xxii., Nos. 14 and 15, p. 369. 



1 3 



