150 CLINICAL BACTERIOLOGY AND H^EMATOLOG 



INTERPRETATION OF RESULTS. 



The chief practical value of the bacteriological examination 

 of pus is derived from the fact that if specific vaccine treat- 

 ment (on Wright's system) is to be used, the vaccine must be 

 prepared from the organism which is causing the disease. If 

 a patient is suffering from a staphylococcic lesion, it is not 

 much use inoculating him for pneumococci, or vice versa. I 

 have seen and obtained such excellent results in some cases 

 by treatment of this nature that very little doubt remains in 

 my mind that the method is one which will be widely used in 

 the future. Except for this the results obtained by a study of 

 the bacteria in pus are more of scientific interest than of prac- 

 tical importance. It is resisting power of the patient and the 

 situation of the collection of pus rather than the bacteria 

 causing it which influences treatment and prognosis. A list 

 of the more important results which are produced by the chief 

 pyogenic bacteria may be of interest. 



Staphylo cocci are the chief producers of localized suppura- 

 tion in the skin such, for instance, as that which occurs in 

 boils, carbuncles, impetig'o, folliculitis, etc. They may cause 

 abscesses in any part of the body, and may also give rise to 

 general infections, ulcerative endocarditis, etc., though this is 

 rare. 



It is in the localized skin affections of staphylococcic 

 origin especially that good results are obtainable by specific 

 vaccination, and a cure may often be obtained in cases which 

 are very intractable by other methods. The doses required 

 are larger than in the case of most bacteria, the best results 

 being obtained when 1,000 to 2,000 millions are given. As 

 these doses sometimes cause severe reactions, it is, however, 

 advisable not to give more than 250 to 500 millions to com- 

 mence with. 



Streptococci usually cause spreading inflammation of the 

 type of erysipelas or cellulitis. They are common causes of 

 osteomyelitis and suppurative and septicsemic or pyaemic pro- 

 cesses connected with the puerperium. 



Treatment of Streptococcic Infections. In acute diseases 

 due to streptococci (septicaemia, erysipelas, puerperal fever, 

 etc.), two specific therapeutic agents are available antistrep- 

 tococcic serum and vaccines. In my opinion the former is 



