ERYSIPELAS 281 



streptococcus-pneumococcus group of organisms, and claims in 

 some cases to have transformed one form into another. 



Streptococci are found in some 16 per cent, of acute 

 circumscribed abscesses. They are, however, especially 

 frequent in spreading inflammations, lymphangitis, cellu- 

 litis, and progressive gangrene, and are a common cause 

 of septicaemia, pyaemia, and puerperal fever. They are 

 met with in about one-third of the cases of infective 

 endocarditis, occasionally in acute osteomyelitis, and are 

 a common cause of post-operative pneumonia, " septic " 

 pneumonia, and the broncho-pneumonias complicating 

 many diseases, particularly influenza. They are frequent 

 in septic wounds and are met with in rheumatic 

 endocarditis and arthritis and occasionally in menin- 

 gitis. 



In erysipelas, streptococci are generally present in the 

 lymphatics at the margin of the zone of redness. These 

 were first isolated by Fehleisen, who described the 

 organism as the Streptococcus erysipelatis , and by inocula- 

 tion experiments on man and animals demonstrated its 

 causal relation to the disease. The experiments on man 

 were made in cases of extensive and inoperable carcinoma 

 and sarcoma, as it had been noticed that malignant 

 tumours were frequently benefited after an attack of ery- 

 sipelas. Several cases were inoculated, and in all but one 

 typical erysipelas developed (see " Coley's Fluid." p. 283). 

 Of Holman's types, pyogenes is most frequent in ery- 

 sipelas (24), but infrequens (6), anginosus and sub-acidus 

 (5 each) also occur. Erysipelas, while commonly caused 

 by streptococci, may occasionally be produced by staphy- 

 lococci, and possibly by the pneumococcus, B. coli, and 

 even the B. typhosus. 



Epidemic sore throat may be caused by streptococci 

 derived by milk infection. This form is virulent for 

 the rabbit, is hsemolytic, and ferments salicin, but does 



