MALIGNANT (EDEMA 519 



depends on several factors virulence of the organism, 

 facilities for rapid multiplication of the organism (e.g. 

 dead and lacerated tissues or blood-clot heavily infected), 

 retardation of escape of toxin (e.g. in a badly drained 

 wound and by interference with the blood supply). 

 Bacterial associations may also play a part. Thus 

 Douglas, Fleming and Colebrook 1 find that proliferation 

 of B. per f ring ens is much more rapid when it grows in 

 symbiosis with streptococcus, staphylococcus, diphtheroid 

 organisms, B. proteus, B. pyocyaneus and a coliform 

 organism, and Emery regards the prognosis as being 

 decidedly better if B. perfringens be present alone, than if 

 streptococci or staphylococci be also present. 



Bacillus (Edematis (Maligni) (Koch) 



Synonyms. Vibrion septique (Pasteur), B. septicus (Mace). 



This micro-organism has given rise to controversy, but 

 it seems clear that an organism agreeing with Pasteur's 

 Vibrion septique is of frequent occurrence in wounds. 

 Vibrion septique and the B. cedematis maligni of Koch 

 are probably identical. The organism occurs in the soil 

 and in the intestine of man and animals. It is an anae- 

 robic bacillus varying in morphology in the tissues and 

 in culture. In a wound definite bacillar forms are present, 

 many sporing, the spores being spherical or ovoid and 

 central or sub terminal and clostridial forms are frequent 

 (Plate XIX, a). In an inoculated animal, the organism 

 may be found in the exudate, liver, spleen and blood 

 in the form of a bacillus or as long sinuous filaments 

 and spores may be observed as early as twenty -four 

 hours after inoculation. In a glucose agar culture the 

 organism may vary from 3 />, to 15 /z, in length and chains 

 of slender bacilli may be present in which the subdivisions 



1 Lancet, 1917, vol. i, p. 604. 



