COCCACE^ AND THEIR PARASITIC RELATIONSHIPS 27 1 



days as opaque granules surrounded by a cloudy but distinctly 

 greenish zone. The organism is being found very frequently 

 in cases of subacute endocarditis/ and is apparently the specific 

 cause of this particular fairly well-defined type of endocarditis. 

 The same organism is found normally in the mouth and pharynx 

 and has been designated also &,s streptococcus salivarius. It is 

 also commonly present in abscesses at the roots of the teeth. 



Streptococcus Pyogenes. — Bacteria were observed in pyemic 

 abscesses by Rindfieisch in 1866 and in the following years this 

 observation was confirmed by numerous pathologists. Klebs 

 (1870-71) recognized the " Microsporon septicum" as the cause of 

 wound intfections and the accompanying fever, as well as the 

 resulting pyemia and septicemia. Ogston (1882) first clearly 

 distinguished between -the chain-form, streptococcus, and the 

 grape-form, staphylococcus, of the pus cocci, not only on the 

 basis of their grouping but also in respect to the types of inflamma- 

 tion with which they are associated. Pure cultures were first 

 obtained by Fehleisen (1883) from erysipelas (Streptococcus 

 erysipelatos) and by Rosenbach (1884) from the pus of wounds 

 {Streptococcus pyogenes). The former produced typical erysipe- 

 las by inoculating the human skin with his cultures. There 

 is no specific distinction between the streptococci found in ery- 

 sipelas and those found in other lesions. The difference in the 

 pathological process depends rather upon the portal of entry of 

 the infection, the virulence of the microbe and the resistance of 

 the host. 



Streptococcus pyogenes lives naturally upon the mucous mem- 

 branes, especially in the pharynx, nose and mouth, the intestine 

 and on the vaginal mucosa. Such streptococci found in normal 

 individuals are relatively non-virulent. Virulent streptococci 

 occur in erysipelatous lesions of the skin, in infected wounds 

 on the inflamed pharyngeal mucosa, and in the lochia, uterine 

 wall and in the circulating blood in puerperal fever. Streptococci 

 are frequently found in pyemic abscesses, bacteremia, meningitis 



' Major, Johns Hopkins Hosp. Bull., 1912, Vol. XXIII, pp. 326-^332. 



