TO BE DUE TO SPECIFIC MICROORGANISMS. 525 



the bacillus of typhoid fever is occasionally found iu the urine during an 

 attack of this disease. 



Letzerich (1887) has described a form of nephritis which he ascribes to a 

 bacillus found by him in the urine and in sections of the kidneys of rabbits 

 inoculated with a culture of this bacillus. 



Lustgarten and Manneberg (1887) in three cases of acute Bright's disease 

 found streptococci in the urine, which they suppose to have had an etiologi- 

 cal relation to the renal disease. The following year Manneberg reported 

 eleven additional cases, in eight of which he found the same streptococcus, 

 which he believes to be different from Streptococcus pyogenes, but this can- 

 not be considered as established. Nor has he shown that the streptococcus 

 obtained by him from the urine was present in the kidneys of his patients, 

 or that pure cultures of this streptococcus produce acute nephritis when in- 

 oculated into lower animals. 



OSTEOMYELITIS. 



The evidence with reference to the presence of Staphylococcus 

 pyogenes aureus in acute osteomyelitis and its probable etiological 

 relation to the cases in which it is found, is given in the article de- 

 scriptive of this microorganism ; but the researches of Kraske (1886) 

 and of Lamelongue and Achard (1890) show that the " golden sta- 

 phylococcus " is not always found in osteomyelitis. The last-named 

 investigators, in a series of thirteen cases, found Staphylococcus 

 pyogenes aureus in four only, and in one of these Staphylococcus 

 pyogenes albus was also present ; in three cases Staphylococcus 

 pyogenes albus was obtained in pure cultures ; in two cases it was 

 associated with Streptococcus pyogenes ; and in two cases a strepto-. 

 coccus was found which resembled Streptococcus pyogenes and yet 

 differed from it in some particulars. 



OTITIS MEDIA. 



In otitis media various microorganisms have been found in pus 

 obtained by paracentesis of the tympanum, as well as in the chronic 

 discharge after perforation ; and there can be but little doubt that 

 these microorganisms are responsible, directly or indirectly, for the 

 inflammatory process and pus formation. The following species are 

 most frequently found in the purulent discharge in recent cases 

 of otitis media : Micrococcus pneumoniae crouposa3 (" diplococcus 

 pneumonise "), Streptococcus pyogenes, Staphylococcus pyogenes al- 

 bus, Staphylococcus pyogenes aureus, Friedlander's bacillus. The 

 following have also been found occasionally : Staphylococcus tenuis, 

 Bacillus tenuis, Micrococcus tetragenus, Bacillus pyocyanus. 



According to Zaufal, Micrococcus pneumonice crouposa3 is most 

 frequently found in cases which result from exposure to cold, while 

 the ordinary pus cocci are more frequently found in otitis which is 

 secondary to specific febrile diseases. 



