224 



INFLAMMATION AND SUPPURATION 



circulation, but this is a very rare occurrence. It often follows, however, 

 when the valves have been previously injured. Orth and Wyssokowitsch 

 at a comparatively early date produced the condition by damaging the 

 aortic cusps by a glass rod introduced through the carotid, and after- 

 wards injecting staphylococci into the circulation. Similar experiments 

 have since been repeated with streptococci, pneumococci, and other 

 organisms, with like result. Ribbert found that if a potato culture of 

 the staphylococcus aureus were rubbed down in salt solution so as to 

 form an emulsion, and then injected into the circulation, some minute 

 fragments became arrested at the attachment of the chordae tendinepe and 

 produced an ulcerative endocarditis. 



FIG. 58. Section of a vegetation in ulcerative endocarditis showing 

 numerous staphylococci lying in the spaces. The lower portion is a 

 fragment in process of separation. 



Stained by Gram's method and Bismarck-brown, x 600. 



Acute Suppurative Periostitis and Osteomyelitis. Special 

 mention is made of this condition on account of its comparative 

 frequency and gravity. The great majority of cases are caused 

 by the pyogenic cocci, of which one or two varieties may be 

 present, the staphylococcus aureus, however, occurring most 

 frequently. Pneumococci have been found alone in some cases, 

 and in a considerable number of cases following typhoid fever 



