524: BACTERIA IN INFECTIOUS DISEASES NOT PROVED 



Klebs and Tommasi-Crudeli; but thei-e is no satisfactory evidence that these 

 or any of the other bacterial organisms found in such situations, when in- 

 jected beneath the skin of a rabbit, give rise to a malarial fever corre- 

 sponding' with the ordinary paludal fevers to which man is subject. 



' ' The evidence upon which Klebs and Tommasi-Crudeli have based their 

 claim of the discovery of a Bacillus malariae cannot be accepted as sufficient ; 

 (a) because in their experiments and in my own the temperature curve in 

 the rabbits experimented upon has in no case exhibited a marked and dis- 

 tinctive paroxysmal character; (6) because healthy rabbits sometimes exhi- 

 bit diurnal variations of temperature (resulting apparently from changes in 

 the external temperature) as marked as those shown in their charts ; (c) be- 

 cause changes in the spleen such as they describe are not evidence of death 

 from malarial fever, inasmuch as similar changes occur in the spleens of 

 rabbits dead from septicaemia produced by the subcutaneous injection of 

 human saliva; (d) because the presence of dark-colored pigment in the 

 spleen of a rabbit cannot be taken as evidence of death from malarial fever, 

 inasmuch as this is frequently found in the spleens of septicaemic rabbits." 



Later researches have also failed to confirm the supposed discovery of 

 Klebs and Tommasi-Crudeli, and it is now generally admitted that there is 

 no satisfactory evidence in favor of the view that microorganisms of this 

 class are concerned in the etiology of the malarial fevers. On the other 

 hand, we have now very extended observations which indicate that the blood 

 parasite discovered by Laveran (1881) in the blood of patients suffering from 

 various forms of malarial fever bears an etiological relation to fevers of this 

 class. This haematozoon belongs to quite a different class of microorgan- 

 isms. It was first described by Laveran as the Oscillaria malarias, but is 

 more frequently spoken of at present as the Plasmodium malariae. 



MEASLES. 



The etiology of measles and of the specific eruptive febrile diseases gene- 

 rally still remains unsettled. The occasional presence of micrococci in the 

 blood of patients with measles, which has been noted, is without doubt due to 

 a secondary or mixed infection by one of the common pyogenic micrococci. 

 In pneumonia occurring during the course of an attack of measles the Mi- 

 crococcus pneumonias crouposae is usually found in the pulmonary exudate. 



No great importance can be attached to the observations made, with re- 

 ference to the presence of microorganisms in this disease, prior to the intro- 

 duction of Koch's plate method and the use of solid culture media for the 

 differentiation of bacteria similar in their morphology. Recently (1892) 

 Canon and Pielicke, of Berlin, have announced the discovery of a minute 

 bacillus in the blood of patients (fourteen) with measles, which may turn out 

 to be the specific infectious agent in this disease. But this cannot be con- 

 sidered demonstrated by the researches thus far made. (See Bacillus of 

 Canon and Pielicke, No. 486.) 



MENINGITIS. 



See Cerebro-spinal meningitis, page 515. 



NEPHRITIS. 



The various microorganisms which have occasionally been found in the 

 urine of cases of nephritis are probably not directly related to the renal dis- 

 ease. Numerous observations are on record which show that pathogenic 

 microorganisms present in the blood or tissues may find their way into the 

 urine during the course of the disease due to their presence. In these cases 

 it is probable that the passage of bacteria into the urine depends upon struc- 

 tural changes in the kidneys ; but that these changes are directly due to the 

 bacteria is by no means established. As an example we may mention that 



