126 PY.EMIA 



The Relations of Pas-microbes to Pyaemia in Man. 



Rosenbach (Mwroorganismen bei den Wundinfections Krankheiten 

 des Menschen, Wiesbaden, 1884) examined six cases of typical 

 pyaemia with a view to determine the nature of the microorganisms 

 present in pyaemie patients. He found the streptococcus pyogenes 

 present in the blood and metastatic deposits in five of them ; in 

 two of these cases, staphylococci were also present, although fewer 

 in number. In only one of them he found staphylococci alone,, 

 and this case recovered. 



Pawlowsky (" Beitrage zur Aetiologie der Pyaemie," Centralblatt 

 f. d. med. Wissen., 1887, JN"os. 24, 25) made a bacteriological exam- 

 ination of the pus of metastatic abscesses in five cases of pyaemia. 

 In four cases he found staphylococcus pyogenes aureus, and in the 

 fifth case, which was remarkable for the extent of the joint compli- 

 cations, he found the streptococcus pyogeues. He believes that the 

 staphylococcus aureus is the usual cause of pyaemia, and especially 

 of that form characterized by multiple abscesses in the internal 

 organs. Large cultures of this coccus suspended in water and 

 injected subcutaneously in rabbits caused death, and at the necropsy 

 multiple abscesses were found. He believes that pyaemia in man 

 occurs when disturbances in the circulation are present, so that 

 floating cocci find places for localization within the bloodvessels. 

 He produced these disturbances artificially by making intravenous 

 injections of cinnabar, and ascertained that the presence of the 

 granular material determined the localization of the microbes. 



Besser, of St. Petersburg, writes in Wratch (St. Louis Medical 

 Journal, May 2, 1888, Nos. 19 and 20) that he has examined, 

 bacteriologically, blood, pus, and parenchymatous fluid from organs 

 in 23 cases of pyaemia. In 8 cases, the staphylococci albi and 

 aurei were found; in 14, the streptococci ; and in 1, the strepto- 

 cocci and staphylococci simultaneously. The microbes were dis- 

 covered, (a) during the patient's life in pus in every one out of 20 

 cases examined ; in blood, in 11 of 12 : and in parenchymatous 

 serum, in 1 of 1 ; (b) after death, in pus, in 17 of 17 ; in blood, 4 

 of 9 ; and in organs, 9 of 14. Besser's predecessors described 23 

 additional cases of pyaemia, in 14 of which staphylococci were 

 found, in 7 streptococci. Total, 46 cases : in 22 staphylococci. in 

 21 streptococci, in 3 both. Besser has also observed that the 

 staphylococcus aureus could transform, under certain conditions, 

 into staphylococcus albus, and vice versa. He was unable to dis- 

 cover the slightest difference between the microbes of suppuration 

 and those of pyaemia. 



Schuller (" Ueber Bacterien bei metastatischen Gelenkentztin- 



