PUS-MICROBES IN SUPPURATIVE AFFECTIONS. 97 



themselves have been previously referred to, and they prove that 

 many of the circumscribed suppurative affections of the skin are 

 caused by direct inoculation with pus-microbes which enter the 

 connective tissue, either through a slight abrasion or through the 

 glands of the skin. 



2. SEROUS CAVITIES. A most interesting investigation of the 

 conditions under which infection of the peritoneum can take place 

 has been made by Grawitz (" Statistischer und experimentell 

 pathologischer Beitrag," Charite" Annalen, Bd. xi. S. 770). From 

 his own experiments he came to the conclusion that the injection 

 into the healthy peritoneal cavity of schizomycetes, pyogenic as 

 well as non-pyogenic, produced no unfavorable results. Perito- 

 nitis was caused only when the microbes were mixed with a caustic 

 fluid, or when the peritoneal cavity contained a fluid which could 

 serve the purpose of a nutrient medium ; also, when the amount of 

 fluid injected exceeded the absorbing capacity of the peritoneum ; 

 or, finally, if the peritoneum was injured at the same time, or the 

 abdomen was opened by a penetrating wound. Strange as it may 

 appear, he claims that the injection into the peritoneal cavity of 

 intestinal contents caused no peritonitis as long as the punctured 

 wound remained aseptic. 



Leyden ("Ueber spontane peritonitis," Deutsche med. Wochen- 

 schrift, 1884. p. 212) demonstrated the presence of streptococci in 

 the exudations of cases apparently spontaneous peritonitis. 



Garre (" Bacteriologische Untersuchungen von serosen Trans und 

 Exsudaten uud Atheromen," Corresbl. /. Sehwdzerdrzte, 1886, No. 

 17) examined carefully for the presence of microorganisms in hydro- 

 cele fluid, serous, peritoneal, and pleural effusions, and the contents 

 of joints the seat of serous synovitis, etc., by means of microscopi- 

 cal examination and cultivation experiments, always with negative 

 results. 



The same author (" Bacteriologische Untersuchuugeu des Bruch- 

 wassers eingeklemmter Hernieu," Fortschritte der Mediein, B. x. 

 S. 486-490), in order to test the observations of Nepveau, accord- 

 ing to whom the transuded fluid in a heroial sac constantly con- 

 tains bacteria, examined eight cases of incarcerated hernia. 

 Although the microscope was used together with delicate reagents 

 for microorganisms and cultivations in gelatin, bacteria were found 

 in only a few instances. The fluid in the sac of non-incarcerated 

 herniaB examined by these methods was found absolutely sterile. 

 Analysis of all the cases examined demonstrated that the length of 

 time the incarceration has existed has no significance as regards the 

 presence of bacteria; since, in recent cases, positive results were 

 obtained, while in a case in which incarceration had existed for 

 eight days the result was negative. Furthermore, the odor of the 



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