132 MALIGNANT EDEMA GAS PHLEGMON 



tion of a soluble toxin. In smaller animals, such as mice and guinea- 

 pigs, a general, systemic infection may develop. In some instances 

 the diseased condition becomes evident within a few hours after inocu- 

 lation. The tissue around the point of introduction becomes edema- 

 tous and the involved area rapidly extends and death may follow 

 within twenty-four hours. Outside of putrid flesh, the bacillus has 

 been found in polluted soil, in which the spores may retain both vital- 

 ity and virulence for a long time. The spores generally develop in the 

 middle of the rod, making it spindle-shaped. 



GAS PHLEGMON 



There are many related bacteria which when introduced through 

 wounds cause death of tissue with the evolution of gas. The best 

 known of these organisms are the following: 



1. The Welch bacillus, discovered in 1891 and known as Bacillus 

 aerogenes capsulatus. 



2. The Ghon-Sachs bacillus, isolated in 1903 from a patient in a 

 case of gaseous gangrene. 



3. The Novy bacillus, found in milk in 1894 and described under 

 the name of Bacillus edematis maligni II. 



4. Hibier's bacillus, found in 1894 in a case of gaseous gangrene, 

 developing after a complicated fracture in which the wound was 

 polluted with earth. 



5. The Klein bacillus, found in the stool of a person suffering 

 from acute enteritis. 



6. The Stolz bacillus, found in a case of gas phlegmon following 

 a fracture. 



Besides the above and other related organisms, the colon and 

 proteus may develop gas phlegmon with rapidly progressive and 

 destructive changes under certain conditions, as for instance, in those 

 debilitated by diabetes. All of these, with the exception of the two 

 last mentioned, are spore-bearing, anaerobic organisms, which are 

 found in polluted soil and become infective only through wounds. The 

 mortality among the infected is high. 



