326 Suppuration 



attained. The serum is .probably both antitoxic and bactericidal 

 in action. 



The success following the serums of some experimenters upon 

 certain cases, and their occasional or constant failure in other 

 cases, have suggested that there is considerable difference between 

 different "strains" or families of streptococci. To obviate this 

 inequahty Van de Velde* has made a polyvalent antistreptococcus 

 serum by using a number of different cultures secured from the 

 most diverse clinical cases of streptococcus infection. Another 

 serum, of Tavelf and Moser,t is made by using cultures from dif- 

 ferent cases of scarlatina. The use of these serums, however, has 

 not given the satisfaction expected, and at the present moment 

 the whole subject of antistreptococcus serums is debatable both 

 from the standpoint of its theoretic scientific basis and its thera- 

 peutic application. 



Streptococcus Vaccine.- — Vaccines made by the method given in 

 the chapter on " Bacterio-vaccines " are now used in all streptococcus 

 infections with varying succes. As, however, there is no knowledge 

 by which one can foretell exactly what course a streptococcus in- 

 fection will pursue, it is impossible to determine with accuracy 

 what advantage results from the treatment. Judged upon its 

 clinical merits, streptococcus vaccine does good, especially when 

 the vaccine is homologous. When homologous vaccine cannot be 

 prepared, preference might next be given the so-called "polyvalent" 

 vaccines made by combining cultures from many sources. Such 

 especially when "sensitized" by admixture with antistreptococcus 

 serum according to the method of Besredka, give promise of benefit 

 upon theoretical grounds. 



Bacteriological Diagnosis and Differentiation. — The micro-organ- 

 isms sometimes appear in the original tissue juices as diplococci or 

 in such short chains as to be mistaken for diplococci. Under such 

 conditions mistakes are easily made and Boston and Pfahler§ were 

 led to believe that erysipelas was caused by a diplococcus. Pairs 

 and short chains also sometimes occur in clumps and can be mis- 

 taken for staphylococci. Cultures upon solid media also appear in 

 such form as to make it difficult to tell the correct grouping. Under 

 such circumstances cultures in liquid media usually offer the char- 

 acteristic rosary-like chains. 



Streptococcus Mucosus (Howard and Perkins) 



This organism, described by Howard and Perkins, || was isolated 

 from a case of tubo-ovarian abscess with generalized infection, and 



* "Archiv. de. m6d. Expfc," 1897. 



t "Deutsche med. Wochenschrift," 1903, No. 50. 



t "Berliner klin. Wochenschrift," 1902, 13. 



§ "Phila. Med. Jour.," Jan. 13, 1900. 



II "Journal of Medical Research," 1901, N. S. i, 163. 



