CHAPTER XX 



STREPTOCOCCIC INFECTION 



History. The streptococcus probably has a much longer ancestry 

 than man and began its assaults on the animal kingdom long before 

 there was any indication of the development of homo sapiens. The 

 unicellular has been the companion of the multicellular through all the 

 evolutionary forms of the latter. Man came into existence as a host 

 to the streptococcus and the victims of the microscopic parasite are as 

 innumerable as the sands of the seashore. Borne on the surface and 

 in the cavities of the greater, the smaller has always been ready to 

 find its way into the vitals of its host and to feed on blood and tissue 

 until the whole became its prey. In peace and in war, among the 

 good and the bad, the wise and the foolish, the streptococcus has always 

 been a factor in determining the mortality rates. As a primary infec- 

 tion there is no part of man's anatomy immune to the invasion of this 

 organism. As a secondary infection, it profits by the lesions induced 

 by other pathogenic bacteria. As a terminal infection, it swarms over 

 every part of dying man, and secures the greater part of the booty of 

 every war, whether waged by itself as principal, as ally or as guerilla. 

 In the earliest medical records wound infection is described. It became 

 the scourge of armies and the military hospital was often more dreaded 

 and more deadly than the field of battle. Indeed, there was a time 

 when all hospitals, both military and civil, became great incubators 

 for the growth and dissemination of pus germs. In the old Hotel Dieu 

 at Paris, the simplest amputations were followed by infection and in 

 a large number this terminated only in death. Even after the dis- 

 covery of surgical anesthesia, when operations were no longer forms 

 of torture, wound infection remained the horrid nightmare of the 

 surgeon. Happily the science of Pasteur and its application to surgery 

 by Lister, opened a new era in the history of surgery. In the first half 

 of the nineteenth century, Gaspard, Leurent and others taught that 

 wounds become infected with invisible organisms, but this was only 



