PUS-MICKOBES. 43 



Chirurgie, 1887 No. 2), has collected 74 excisions of tuberculous 

 joints made at the Canton Spital in St. Gall, for the purpose of 

 ascertaining the immediate effects of the operation in causing gene- 

 ralization of the tuberculosis. Of this number, 11 died, and in 2 

 of them death was caused by miliary tuberculosis soon after the 

 operation, the disease being produced by inoculation from the 

 wound surfaces. He next collected 837 resections from other 

 sources, with 225 deaths ; of these, 26 cases of acute miliary tuber- 

 culosis could be traced to inoculation during the operation. 



3. PUS-MICROBES. When by mechanical, chemical, or other 

 injury, the vitality of tissue cells is lowered, a door is opened for 

 the admission of such organisms which, having once penetrated the 

 tissues or the blood, find a suitable soil for multiplication, and these 

 may prove, by their mere numbers, or by their effects, injurious or 

 fatal to the whole body. Nothing can demonstrate this better than 

 the experiments recently made by Orth and Wyssokowitsch, who 

 found that staphylococci could be injected into the blood of a 

 rabbit without apparent injury to it, but if before the injection a 

 slight mechanical injury was inflicted on the valve of the heart, 

 typical endocarditis was at once produced. 



To Rosenbach (" Bemerkungen zur Lehre von der Endocarditis, 

 mit besonderer Berucksichtigung der experimentellen Ergebnisse," 

 Deutsche med. Wochenschrift, B. xiii. Nos. 32-33, 1887) belongs the 

 credit of having first studied the influence of trauma in the locali- 

 zation of microbes upon the valves of the heart in cases of artifi- 

 cially-produced ulcerative endocarditis. He found in his experi- 

 ments and in post-mortem examination in cases of ulcerative 

 endocarditis, microbic emboli in the valves and in the infarcts of 

 other organs, and classifies this affection with pya3mia. The more 

 frequent occurrence of endocarditis in the left side of the heart, he 

 explains by assuming that the microbe finds a better soil in the 

 arterial blood, as when the affection occurs in the foetus during 

 iutra-uterine life, when the blood in both sides of the heart is of 

 about the same composition, the valves on both are affected with 

 the same frequency. 



Wyssokowitsch (" Beitrage zur Lehre von der Endocarditis." 

 Virchow's Archiv, B. ciii. Heft 6) has determined with great 

 accuracy the influence of traumatism in causing localization of 

 pathogenic germs, and has found that, by introducing a rod into 

 the jugular vein, he was able to cause laceration of the valves, 

 and that then, on subsequent injection of a culture of staphylo- 

 cocci into the blood, ulcerative endocarditis developed at the seat 

 of injury. The effects of the traumatic lesion in this instance are 

 no doubt chiefly due to the production of a locus minoris resistentice 

 in the endothelial and connective-tissue cells, as the result of the 



