138 EKYSIPELAS. 



erysipelas, phlegmonous inflammation, or purulent pleuritis. The 

 streptococcus of erysipelas produces the disease in rabbits almost 

 invariably, and sometimes phlegmons or peritonitis in man. The 

 streptococcus of pus sometimes produces erysipelas in the rabbit. 

 These three streptococci are similar in cultures and appear to be 

 one and the same whose manifestations may vary. 



Smirnoff found in one case of erysipelas the specific microbe in 

 the metacarpo-phalangeal joints of the left hand which was the seat 

 of the disease. In the case of a man who had died of erysipelas 

 enormous colonies of the streptococcus were found in the right 

 shoulder and knee-joints. The synovia! fluid injected into rabbits 

 occasioned erysipelas migrans. 



Verneuil and Clado (" De PIdentite de PErysipele et de la 

 Lymphangite-aigue," Compt. rend., T. 108, No. 14) found in the 

 pus of four cases of typical suppurative lymphangitis only the 

 cocci of erysipelas, and by inoculations with them produced ery- 

 sipelas artificially in rabbits. The authors consequently came to 

 the conclusion that erysipelas and lymphangitis are only two forms 

 of one and the same acute, infectious, parasitic disease. 



Kahlden (Centralblatt f. Bacteriologie und Parasiten-kunde, B. i. 

 S. 22), after a careful study of the recent literature on erysipelas 

 and the difference in opinion on the pathogenic properties of the 

 streptococcus erysipelatosus, remarks that the subtility in the differ- 

 ences between the morphology and the cultures of the microbe of 

 erysipelas and the streptococcus of suppuration are undoubtedly 

 the reason why no uniformity of opinion exists in regard to their 

 specific pathogenic effects, especially as to the possibility of Fehlei- 

 sen's streptococcus producing suppuration. To this I might add 

 that not every superficial diffuse inflammation of the skin is ery- 

 sipelas, and not every abscess occurring during, or soon after, an 

 attack of erysipelas should be considered as a product of this 

 disease. The surgeon will do well to hold to the teachings of 

 Fehleiseu, until more convincing proof shall have been furnished 

 of the pathogenic identity of the streptococcus of erysipelas and 

 the streptococcus of suppuration. 



