112 SEPTICAEMIA. 



they do not make emboli ; they are not always cocci, sometimes 

 rods. 



At the last meeting of the German Medical Congress (Berl. klin. 

 Woohensehrift, 1888, No. 18) Jiirgensen read a paper on krypto- 

 genetic septico-pysemia, in which he referred to 100 cases of this 

 disease which had come under his own personal observation, and 

 in which it was impossible to locate the source of infection. The 

 microbes found were either streptococci or staphylococci, or both 

 together, in the same patient. He stated that the streptococcus 

 circulated in the blood, while the staphylococcus produced local 

 processes. 



Yidal (Gf-az. hebdom., No. 22, 1888) has reported to the Acade- 

 mic de Medecine de Paris the results of his studies of the "forme 

 septicemique pure " in puerperal fever, of typhoid type without 

 suppuration. In all of his cases he found the streptococcus pyo- 

 genes, and from this, and the result of his culture and inoculation 

 experiments, he comes to the conclusion that it is impossible, in the 

 present state of our knowledge, to distinguish between the various 

 forms of streptococci, and that one and the same form can set up 

 any of the various forms of puerperal infection. 



Besser (St Louis Medical and Surgical Journal, 1888, No. 2) 

 states that he has examined 22 additional cases of traumatic septi- 

 caemia, and found streptococcus in every one of them. During the 

 patient's life he discovered the microbe (a) in blood, in 4 of 1 6 

 cases examined ; (6) in pus or fluid discharge from the primary 

 focus, in 17 of 17 ; (c) in urine, in 3 of 4, and (d) in sputa, in 3 of 

 3 ; while after death the microorganism was present (a) in blood, 

 in 7 of 15 ; (b) in organs, in 16 of 18 ; and (c) in pus or uterine 

 discharges, in 12 of 12. In 6 of 22 staphylococci were simul- 

 taneously detected, side by side with masses of bacteria of many 

 other species. In 3 cases, however, the streptococcus alone could 

 be found. The author supposes that septicaemia is produced solely 

 by the streptococcus. The microbe itself penetrates into the 

 organism but very seldom. 



From the above historical consideration it becomes evident that 

 the essential cause of septicaemia has as yet not been demonstrated. 

 The streptococcus pyogeues has been found most frequently in the 

 products of septic inflammations, but whether any of the pus- 

 microbes alone are capable of producing true sepsis remains to be 

 demonstrated by future research. As the introduction into the 

 circulation of the products of putrefaction is followed by a corn- 

 plexus of symptoms which closely resemble septicaemia, and as dif- 

 ferent microbes have been cultivated from septic patients, it would 

 seem that this disease can be produced by any of the microbes 

 which, after their introduction into the organism, have the capacity 



