PUS-MICROBES IN SUPPURATIVE AFFECTIONS. 101 



gravity of the symptoms which attend the disease, as compared with 

 other suppurative processes, is owing to the anatomical location and 

 structure of the inflamed tissues, rather than to any difference in 

 the microbic cause. 



Rosenbach ( u Vorlaufige Mittheilung iiber die acute Osteomye- 

 litis beim Menschen erzeugendeu Microorganismen," Centralblatt f. 

 Chirurgie, 1884, p. 65), as early as 1881, cultivated the staphy- 

 lococcus from osteomyelitic pus. In one case the yellow and the 

 white staphylococcus were found combined, in another case the 

 staphylococcus albus alone, while in a third case the staphylococcus 

 aureus and the streptococcus pyogenes were found present together. 

 Rosenbach produced the same result in his experiments by injection 

 of a pure cultivation of pus-microbes from a furuncle of the lip, as 

 Struck did with cultivations from the pus of osteomyelitis, and with 

 osteomyelitic pus injected into the subcutaneous connective tissue he 

 produced an ordinary abscess. Recurrent attacks of osteomyelitis 

 years after the primary disease, he explains by assuming that after 

 the first attack some of the microbes are left in the tissues, and 

 remain in a latent condition until at some subsequent time local 

 conditions are created which enable them again to display their 

 pathogenic properties. Ogston found the staphylococcus in the pus 

 of a case of acute osteomyelitis. 



Struck (" Ueber eine im Kaiserlichen Gesundheitsamt ausge- 

 fiihrte Arbeit, welche zur Entdeckung des die acute infectiose 

 Osteomyelitis erzeugenden Microorganism us gefiihr that," Deutsche 

 med. Wochenschrift, 1883, No. 46) obtained from the pus of an 

 acute case of osteomyelitis upon gelatin, an orange-yellow culture; 

 the identity of this cultivation with the staphylococcus pyogenes 

 aureus was soon generally recognized. By injecting a pure culture 

 into the circulation of animals which had been subjected a few days 

 before to injury of bone, as contusion or fracture, he produced a 

 suppurative inflammation at the seat of trauma. 



Even before the microbic cause of acute osteomyelitis was under- 

 stood, Kocher (" Die acute Osteomyelitis mit besouderer Riicksicht 

 auf ihre Ursachen," Deutsche Zeitschrift /. Chirurgie, B. xi. S. 87) 

 believed that the infection, in some cases at least, occurred through 

 the intestinal canal, and made some experiments to prove this point. 

 In dogs he produced subcutaneous fractures, and then fed them 

 large quantities of putrid material, and, in some cases, succeeded in 

 producing suppuration at the seat of injury. In his clinical expe- 

 rience he also observed that in many cases of acute suppurative 

 osteomyelitis the premonitory symptoms pointed to the gastro- 

 intestinal canal as the portio invasionis. 



Krause (" Ueber einen bei der acuten infectiosen Osteomyelitis des 

 Meuschen vorkommenden Mierococcus," Fortschritte der Medicin, 



