666 Gaseous Edema 



bryos, and there multiplied sufficiently to bring about the 

 subsequent death of the mother. 



After death, when the blood is no longer oxygenated, the 

 bacilli grow rapidly, with marked gas-production, which in 

 some cases is said to cause the body to swell to twice its 

 natural size. The effect upon guinea-pigs does not differ 

 from that upon rabbits, though gaseous phlegmons are 

 sometimes produced. 



Pigeons, when subcutaneously inoculated in the pectoral 

 region, frequently succumb. Following the injection gas- 

 production causes the tissues of the chest to become emphy- 

 sematous. The birds usually die in from seven to twenty- 

 four hours, but may recover. 



Intraperitoneal inoculation of animals sometimes causes 

 fatal purulent peritonitis. 



Sources of Infection. The infection seen in man usually 

 occurs from wounds into which earth has been ground, 

 as in the case of a compound, comminuted fracture of the 

 humerus, with fatal infection, reported by Dunham, or in 

 wounds and injuries in the neighborhood of the perineum. 



Among the twenty-three cases reported by Welch and 

 Flexner * we find wounds of the knee, leg, hip, and forearm, 

 ulcer of the stomach, typhoid ulcerations of the intestine, 

 strangulated hernia with operation, gastric and duodenal 

 ulcer, perineal section, and aneurysm, as conditions in which 

 external or gastro -intestinal infection occurred. 



Dobbin,! P. Ernst, J Graham, Stewart and Bald win, and 

 Kronig and Menge|| have studied cases of puerperal sepsis 

 and sepsis following abortion either caused by the bacillus, 

 or in which it played an important role. 



Williams ** has found the bacillus in a case of suppura- 

 tive pyelitis. 



The symptoms following infection are quite uniform, con- 

 sisting of redness and swelling of the wound, with rapid 

 elevation of temperature and rapid pulse. The wound usu- 

 ally becomes more or less emphysematous, and discharges a 

 thin, dirty, brownish, offensive fluid that contains gas bubbles 



* "Journal of Experimental Medicine," vol. I, No. 1, Jan., 1896. 



f'Bull. Johns Hopkins Hospital," Feb., 1897, No. 71, p. 24. 



J "Virchow's Archiv," Bd. cxxxm, Heft 2. 



"Columbus Med. Jour.," Aug., 1893. 



(I " Bakteriologie des weiblichen Genitalkanals," Leipzig, 1897. 



**"Bull. Johns Hopkins Hospital," April, 1896, p. 66. 



