300 Wound Infection; Suppuration 



called "terminal infections," and hastening the fatal issue. 

 Of 793 autopsies at the Johns Hopkins Hospital, 255 upon 

 cases dying of chronic heart or kidney diseases, or both, were 

 sufficiently well studied, bacteriologically, to meet the re- 

 quirements of a statistical inquiry. Tuberculous infections 

 were not included. Of the 255 cases, 213 gave positive 

 bacteriologic results. "The micro-organisms causing the in- 

 fections, 38 in all, were Streptococcus pyogenes, 16 cases; 

 Staphylococcus pyogenes aureus, 4 cases; Micrococcus lan- 

 ceolatus, 6 cases; gas bacillus (B. aerogenes capsulatus), 

 three times alone and twice combined with Bacillus coli 

 communis; the gonococcus, anthrax bacillus, Bacillus pro- 

 teus, the last combined with Bacillus coli; Bacillus coli 

 alone; a peculiar capsulated bacillus, and an unidentified 

 coccus." 



It is interesting to observe in how many cases the 

 streptococcus was present. All the streptococci found 

 may not have been Streptococcus pyogenes, but for conve- 

 nience in his statistics they were regarded as such. 



The presence of streptococci in the blood in scarlatina has 

 been observed in 30 cases by Crooke, by Frankel and Tren- 

 denburg, Raskin, Leubarth, Kurth, and Babes. In 1 1 cases 

 of scarlatina studied by Wright * a general streptococcus 

 infection occurred in 4, a pneumococcus infection in i, and a 

 mixed infection of pyogenic cocci in i. 



Lemoine f found streptococci in the blood during life in 2 

 out of 33 cases of scarlet fever studied. Pearce { studied 17 

 cases of scarlatina and found streptococci in the heart's 

 blood and liver in 4, in the spleen in 2, in the kidney in 5 

 cases. In 2 of the cases Staphylococcus pyogenes aureus 

 was associated with the streptococcus. 



The streptococcus is the most common organism found in 

 the suppurative sequelae of scarlatina, frequently occurring 

 alone; sometimes with the staphylococci ; sometimes with 

 the pneumococci. Councilman found secondary infection 

 by the streptococcus more widespread in variola than in 

 any other disease. 



Virulence. In the great majority of cases, streptococci 

 isolated from human beings are pathogenic for rabbits and 

 mice. Rats become ill when injected with large doses, but 



* "Boston Med. and Surg. Jour.," March 21, 1895. 



f "Bull, et Mem. Soc. d'Hop. de Paris," 1896, 3 s., xm. 



J "Jour. Boston Soc. of Med. Sci.," March, 1898. 



