514 A MANUAL OF BACTERIOLOGY 



Weinberg gives the following figures for ninety-one 

 cases : 



B. perfringens . . . .77 per cent. 

 B. cedematiens . . .34 ,, 



B. sporogenes . . . .27 



B.fallax .... 16-5 



Vibrion septique . . .13 ,, 



B. perfringens was present alone in twenty-nine of the 

 cases, B. cedematiens in five, and Vibrion septique in one ; 

 the first two were present together in three of the cases, 

 the first and the last in three, and all three in two ; in 

 the remaining cases various combinations of these with 

 other anaerobes were present. The B. perfringens was 

 the most, and the Vibrion septique the least, frequent 

 organism. 



The characteristic lesion of the muscle in gas gangrene 

 is necrosis, due to the toxins elaborated by the organisms. 

 The muscle fibres pass through the stages of cloudy 

 swelling, with loss of striation, coagulation necrosis and 

 solution. The organisms, which are usually present in 

 enormous numbers, lie in the connective tissues and for 

 the most part do not invade the other structures, and 

 extend to neighbouring muscles by spreading in the sub- 

 cutaneous tissue or the deep connective tissue trabeculse. 

 The most striking feature of the lesion in the muscles is 

 the entire lack of any inflammatory reaction, the muscle 

 fibres are quiescent, and wandering cells are completely 

 absent. The infection of the muscles is purely an incident 

 the anaerobic bacilli have no specific action upon muscle, 

 nor do they find in it any substances which are especially 

 necessary for their metabolism. It is in deep penetrating 

 wounds that the organisms thrive best, and such wounds 

 in the limbs involve muscle. Were the thoracic and 

 abdominal viscera of less immediate importance to the 

 life of the individual, there is no reason to suppose that 



