48 LOCALIZATION OF MICKO-OKG ANISMS . 



cannot fail in furnishing conditions which determine filtration of 

 germ-containing blood. If the antecedent pathological product is 

 the result of a previous infection and serves as a medium for 

 localization of another kind of pathogenic germs, we speak of the 

 combined process due to the presence of two varieties of micro- 

 organisms as a mixed infection. The first positive proof of the 

 existence of such secondary processes was furnished by Brieger and 

 Ehrlich. ("Ueber das Auftreten des malignen Oedems bei Typhus 

 abdominalis," Berl. Min. Wochenschrift, 1882, No. 44.) These 

 observers saw a malignant oedema develop at the point where musk 

 was injected hypodermatically in a severe case of typhoid fever. 

 They found that in such cases a predisposition is produced by an 

 existing disease to the growth and multiplication of microorgan- 

 isms which may have been previously present in the organism 

 without producing any pathological lesions. Koch, in his article 

 on u Etiology of Tuberculosis/ 7 alludes to the occurrence of mixed 

 infections, as he has seen at the same time bacilli and micrococci 

 present in tubercular products Further, he has observed the 

 bacillus of anthrax side by side in the same tissues and has seen 

 micrococci in the tissues of patients suffering from typhus fever. 

 In reference to the occurrence of micrococci in tubercular deposits 

 in the lungs and spleen, he explained their presence by assuming 

 that they entered the circulation through ulcerations of the tongue, 

 and that they became arrested in the capillary vessels which had 

 lost their normal resisting power by the tubercular process. 



Samter (" Mischinfection von Tuberkelbacillen u. Pneumonie- 

 kokken," Berl. Min. Wochenschrift, 1884, No. 25) discovered in the 

 pneumonic sputa of a man sixty-five years of age, who previously 

 had suffered from a latent bronchial catarrh, besides cocci of pneu- 

 monia numerous bacilli of tuberculosis. The necropsy revealed 

 old tubercular deposits in the right, and more recent deposits in 

 the left lung, and around the latter pneumonic consolidation of the 

 parenchyma of the lung. He believed that the pneumonic foci 

 furnished a favorable soil for the localization and growth of the 

 bacillus of tuberculosis. Heubner and Bahrdt ( a Zur Kenntniss 

 der Geleukeiterung bei Scharlach," Berl. Min. Wochenschrift, 1884, 

 No. 44) have described the post-mortem appearances of a boy 

 fourteen years of age who had suffered from multiple suppurative 

 synovitis after an attack of scarlatina. The metastatic suppura- 

 tive process could be traced directly to a circumscribed purulent 

 inflammation of the right tonsil which implicated an adjacent vein, 

 which became the seat of a purulent thrombo-phlebitis, and the 

 point of distribution of infective emboli ; chain cocci were found 

 in the pus of the joints and even in the patient's blood. 



Frankel and Freudenberg (" Ueber Infection bei Scharlach," 



