342 Gaseous Edema 



Brieger and Ehrlich* have reported 2 cases of malignant edema 

 _ in man. Both occurred in typhoid fever patients subcutaneously 

 injected with musk, the infection no doubt resulting from impurities 

 in the therapeutic agent. 



Grigorjeff and Ukkef have observed another interesting case of 

 typhoid fever with intestinal ulcerations, through which infection 

 by the bacillus of malignant edema took place. The case was 

 characterized by interstitial emphysema of the subcutaneous tissue 

 of the neck and breast, gas bubbles in the muscles, and a transforma- 

 tion of the entire liver into a spongy porous mass of a grayish-brown 

 color. The spleen was enlarged and soft, and 'contained a few gas- 

 bubbles. Though the writers consider this organism to be the bacil- 

 lus of malignant edema, the general impression one receives from the 

 description of the lesions suggests that it was Welch's Bacillus 

 aerogenes capsulatus. 



Immunity. — Cornevin found that the passage of the bacillus 

 through white rats diminished its virulence, and that the animals 

 of various species that recovered were immune against subsequent 

 infection with the virulent organisms. Roux and Chamberland| 

 found that the filtered cultures were toxic and that animals could be 

 immunized by injection with this toxic filtrate. 



GASEOUS EDEMA 



Bacilltjs Aerogenes Capsulatus (Welch) 



Synonym. — Bacillus Welchii; Bacillus enteritidis sporogenes; Bacillus phleg- 

 mone emphysematose; Bacillus perfringens; Bacillus einphysematis vaginas; 

 Granulobacillus saccharobutyricus immobilis liquefaciens; Welch's gas bacillus. 



General Characteristics. — A large, stout, non-motile, non-flagellate, sporogen- 

 ous, non-chromogenic, purely anaerobic, markedly aerogenic, doubtfully patho- 

 genic bacillus, easily cultivated in artificial media, readily stained by the ordinary 

 methods and by Gram's method. 



This disease is caused by an interesting micro-organism described 

 by Welch, and subsequently studied by Welch and Nuttall,§ Welch 

 and Flexner,|| and others. Welch said at the meeting of the Society 

 of American Bacteriologists held at Philadelphia, December 30, 1904, 

 that he believed this organism to be identical with Khne's Bacillus 

 enteritidis sporogenes,** and that it belongs to the butyric acid 

 group. It is probably also identical with Bacillus phlegmone em- 

 physematose of Frankel.ft In many systematic writings the organ- 

 ism is now called Bacillus welchii. English writers identify it 



* "Berliner klin. Wochenschrift," 1882, No. 44. 



t " Militar-medizin. Jour.," 1898, p. 323. 



t "Ann. de I'lnst. Pasteur.," 1887. 



§ Bull, of the Johns Hopkins Hospital," July and Aug., 1892, vol. viii,No. 24. 



II "Jour, of Experimental Medicine," Jan., 1896, vol. i, No. i, p. 6. 

 ** "Centralbl. f. Bakt. u Parasitenk," i895,xviii, 737. 

 tt "Centralbl. f. Bakt.," etc., Bd. xiii, p. 13. 



