322 Suppuration 



tina and found streptococci in the heart's blood and liver in 4, in 

 the spleen in 2, in the kidney in 5 cases. In 2 of the cases Staphy- 

 lococcus pyogenes aureus was associated with the streptococcus. 



The streptococcus is the most common organism found in the 

 suppurative sequelae of scarlatina, frequently occurring alone; 

 sometimes with the staphylococci; sometimes with the pneumococci. 



Rosenow* cultivated streptococci from cases of arthritic, cholecys- 

 titic and ulcerative gastritis. He confirmed . the observation of 

 Forsenert that streptococci taken from an organ in which they have 

 successfully colonized in one animal and injected into a new animal, 

 colonize by preference in the organs corresponding to those from 

 which they were taken. 



Virulence. — Streptococci isolated from human beings vary greatly 

 in pathogenic action upon the laboratory experiment animals. In 

 many cases, although they have induced a fatal iUness in human 

 beings, they are without effect upon the lower animals; in other 

 cases, although from a more simple lesion that recovered, they are 

 extremely fatal for the most susceptible animals, rabbits and mice. 

 Rats sometimes become ill when injected with virulent cultures in 

 large doses, but usually recover. Guinea-pigs, cats, and dogs are 

 but slightly susceptible even when the cultures are virulent. Large 

 animals, like sheep, goats, cattle, and horses, react very slightly 

 to large doses, but sometimes suffer from abscesses at the seat of 

 injection. Mice die in from one to four days from general infection. If 

 the organisms are less virulent, they die in from four to six days with 

 edema and abscess formation at the site of inoculation, and subsequent 

 invasion of the body. All streptococci seem to be most pathogenic 

 for that species of animal from which they have been isolated. 



If the ear of a rabbit be carefully scarified, and cutaneously in- 

 oculated with a small quantity of a pure culture, local erysipelas 

 usually results, the disturbance passing away in a few days and the 

 animal recovering. If, however, the streptococcus be highly viru- 

 lent, the rabbit may die of general septicemia in from twenty-four 

 hours to six days. The cocci may then be found in large numbers 

 in the heart's blood and in the organs. In less virulent cases minute 

 disseminated pyemic abscesses are sometimes found. 



When mildly virulent cultures of the variety called Streptococcus 

 viridans are intravenously injected into rabbits, some time elapses 

 before much disturbance is noted, then the animal becomes ill and 

 eventually dies of cardiac disease. Verrucose endocarditis with 

 marked calcification of the mitral valve, with secondary metastatic 

 subacute glomerulonephritis was observed in those cases which were 

 carefully studied by Libman.t 



* Jour. Amer. Med. Asso.," 1913, Lx, 1223; Lxi, 1947; 1914, Lxni, 1835; "]o\a. 

 Inf. Dis.," 1915, XVI, No. 2, p. 240. 



t Nordiskt diciniskt Archiv., 1902, xxxv, p. i. 



t Amer. Jour. Med. Sci., 1910, CXL, 516; X912, CLXiv, 313; Trans. AsSo. Amer. 

 Phys., 1912, XXVII, 157. 



