KELATION TO PHLEGMONOUS INFLAMMATION. 137 



tion of the sheaths of the tendons of the hand occurred. Soon 

 after death blood was taken from the heart, and with it a solid 

 nutrient medium was inoculated, with the result of producing a 

 culture which in every respect resembled the streptococcus of ery- 

 sipelas. 



Simoue observed a case of pyaemia which developed in a patient 

 suffering from erysipelas, and the bacteriological study of this case 

 led him to assert that the streptococcus of suppuration and of ery- 

 sipelas were the same. His experiments on animals with both 

 organisms yielded the same results. 



Rheiner (" Beitrage zur pathologischen Anatomic des Erysipels 

 bei Gelegenheit der Typhus-epidemie in Zurich," 1884, Virchow's 

 Archiv, B. c. S. 185) found Fehleisen's streptococcus in all cases of 

 traumatic erysipelas which he examined, but was unable to find it 

 in two cases of gangrenous erysipelas following typhus. In these 

 cases he found bacilli which he believed were identical with Klebs- 

 Eberth's bacillus of typhus. 



Max Wolff (" Bacterienlehre bei accidentellen Wund-Krank- 

 heiten," VirchoVs Archiv, B. Ixxxi. S. 408), from a review of this 

 subject, and a number of original observations, came to the conclu- 

 sion that certain micrococci produced some chemical poison which 

 occasioned erysipelas. 



The distinction, moreover, between erysipelas and phlegmonous 

 processes was formerly not accurately made, and Till man ns even 

 believed that the germs of erysipelas could produce septic disease. 



To complicate this subject still more, Bonome and Bordini (Cen- 

 tralblattf. Chirurgie., No. 7, 1887) claim that they have found the 

 staphylococcus in two cases of erysipelas. The authors assert that 

 in the fluid removed from the bullse of a case of facial erysipelas 

 they found the staphylococcus pyogenes aureus and no streptococci. 

 Culture experiments were made, and the product was a luxuriant 

 growth of the yellow coccus. Inoculations in rabbits yielded 

 positive results with recovery. 



The second case was one of phlegmonous erysipelas of the face, 

 from which they cultivated the staphylococcus pyogenes citreus. 

 Inoculations with this culture were again followed by positive 

 results. From these observations the authors conclude that other 

 microorganisms than the streptococcus of Fehleisen can produce 

 erysipelas. At a recent meeting of the Academy of Medicine in 

 Paris, Doyen read a paper on the relations existing between ery- 

 sipelas and puerperal fever. By means of clinical observations 

 and experimental inoculations the author claimed to have demon- 

 strated that the puerperal streptococcus, which is the microorganism 

 characteristic of that affection, almost always produces erysipelas 

 and a small abscess in the rabbit. In women, it often produces 



