328 PATHOGENIC MICROORGANISMS 



upon the relation between the virulence of the incitant and the resist- 

 ance of the subject. Apart from the formation of localized abscesses, 

 staphylococci are common as the incitants of surgical suppurations 

 and wound infections. The large majority of acute suppurative in- 

 flammations of bone (osteomyelitis) are caused by staphylococci. Ab- 

 scesses of the brain, of the liver, and of the lung may be due to this 

 microorganism. It may give rise to ascending infections of the genito- 

 urinary tract, leading to pyelonephritis. Empyema or peritonitis may 

 be caused by its entrance into the serous cavities from the lung or 

 bowel. When gaining access to the circulation from some localized 

 focus, it gives rise to septicemia and may lead to malignant endocarditis 

 and, by secondary localization in the viscera, to general pyemia. As 

 the incitant of septicemia it can frequently be found by blood culture 

 during the life of the patient. Puerperal sepsis is not infrequently a 

 staphylococcus disease. Of recent years several authors have claimed 

 direct etiological relationship for the Staphylococcus pyogenes aureus 

 with acute articular rheumatism. 1 While not unlikely, this claim is 

 not, at present, substantiated by sufficiently exact evidence. 



Apart from the local inflammatory reactions called forth by 

 staphylococcus invasion, all such infections, if severe or prolonged, 

 give rise to profound toxic manifestations evidenced by characteris- 

 tically irregular temperature (the so-called "septic type"), by head- 

 ache, nausea, and general malaise, and not infrequently by chills. 

 Prolonged chronic infection with staphylococci may give rise to the 

 so-called amyloid changes in liver, spleen, and kidneys. 



Toxic Products. Endotoxins. The dead bodies of staphylococci 

 injected into animals may occasionally give rise to abscess formation, 

 and, 2 if in sufficient quantity, may cause death. To obtain the latter 

 result, however, large quantities are necessary, the endotoxic substances 

 within the dead cell body of these microorganisms being probably neither 

 very poisonous nor abundant. 3 



That dead cultures of Staphylococcus aureus exert a strong positive 

 chemotaxis for leucocytes was shown beyond question by the experi- 

 ments of Borissow. 4 



Hemolysins. In 1900 Kraus 5 noticed the hemolytic action of 



1 A. H. Weis, Inaug.-Diss., Berlin, 1901. 



2 Schattenfroh, Arch, f . Hyg., xxxi, 1887. 



sv. Lingelsheim, " Aetiol. u. Therap. d. Staph. Krank.," Wien, 1900. 

 * Borissow Zieglers Beitr., xvi, 1894. 

 8 Kraus, Wien. klin. Woch., iii, 1900. 



