3i6 Suppuration 



the kidneys, infarcts are formed by the bacterial emboli. The 

 Malpighian tufts of the kidneys are sometimes full of cocci, and be- 

 come the centers of small abscesses. 



Virulence. — Experiments have shown that both Staphylococci 

 aureus and albus exist in attenuated and virulent forms, and there 

 is every reason to believe that in the majority of instances they in- 

 habit the surface of the body in a feebly virulent condition. 



Agglutination. — KoUe and Otto* have found that immune anti- 

 staphylococcic serums agglutinate the staphylopocci. The reaction- 

 is not specific and is peculiar. All pathogenic staphylococci are 

 agglutinated; non-pathogenic cocci are not agglutinated. The re- 

 action cannot, therefore, be used for specific differentiation. 



Specific Therapy. — The treatment of staphylococcus infections 

 with immune serum has not met with encouraging success. Vi- 

 querat,t Denys and van de Velde,} and Neisser and Wechsberg§ and 

 others have experimented in this direction, but the literature con- 

 tains very little evidence that beneficial results have followed the 

 employment of antistaphylococcus serums. 



Bacterio-vaccination. — Although specific serums have failed, a 

 promising form of specific treatment for subacute and chronic 

 staphylococcic infections has been introduced by A. E. Wright, || 

 who first isolates from the lesion the particular strain of staphylococci 

 by which it is caused, cultivates this artificially, suspends the or- 

 ganisms in an indifferent fluid, of which a given quantity contains a 

 known (counted) number, kills the organisms by heating them for 

 an hour at 6o°C., and then uses them by subcutaneous injection for 

 producing increased resistance on the part of the patient.** The 

 beginning dose is loo million cocci. Doses are given every six or 

 eight days, increasing the dose each time, until, if necessary looo 

 million are administered at a dose. 



The treatment is controlled by studying the "opsonic index" 

 iq.v.), the objects being the avoidance of the "negative phase" or 

 condition of diminished resistance, and the progressive establish- 

 ment of the positive phase or stage of increased resistance. As the 

 resistance increases the patient rapidly improves, and many cases 

 of obstinate acne, furunculosis, and other pyogenic infections have 

 quickly recovered under this treatment. 



Staphylococcus Citreus (Passet) 



An organism similar to the preceding, except that its pathogenicity 

 for animals is doubtful, its growth on agar-agar and potato of a 

 brilliant lemon-yellow color and that it does not Hquefy gelatin. 



* ttn 



"Zeitschrift fur Hygiene," etc., 1902, xli. 

 t Ibid., xvni, 1804, p. 483. 

 *"LaCellufe,"i89S,xi. 

 § "Zeitschrift fur Hygiene," igoi, jcxxii. 



II "Lancet," March 29, 1902, p. 874; "Brit. Med. Jour.," May 9, 1903,?. 1009. 

 ** See Bacterio-vaccination. 



