248 PHARMACEUTICAL BACTERIOLOGY 



The surgeons of today seek to prevent all pus formation. All surgical 

 operations are, and should be, without infection of any kind, hence there 

 is,'"and should be, no pus formation. Cuts or incisions, which heal without 

 pus formation, are said to show "primary union" or to heal by "first 

 intention," terms which were in constant use when "Listerism" was ex- 

 tensively introduced into surgical practice about 1875, but which are very 

 rapidly falling into disuse, the surgeons of today simply speaking of 

 infected or non-infected wounds, as the case may be. 



Occasionally a primary invasion by the staphylococcus group, {Staphy- 

 lococcus albus (white pus), S. aureus and S. citreus (yellow pus). Bacillus 

 pyocyaneus (blue pus, comparatively rare)} is followed by an invasion by 

 the Streptococcus which may result in a more or less widespread infection 

 commonly known as "blood poisoning," accompanied by redness, swelling 

 and pain, with final more or less extended tissue destruction and necrosis. 



As to which species or variety of infecting microbe initiates the primary 

 infection depends upon place and opportunity. The staphylococcus 

 group being most common and most widespread, naturally is most likely 

 to be the predommating infecting agent. We may expect streptococcus 

 infection in the presence of abundant decaying organic matter, stable 

 manure, cattle pens, etc. The tetanus infection in old garden soils, in 

 hay, in old stable manure and in the mud and dust of much traveled roads. 

 For example, the extensive infection of wounds by the tetanus bacillus in 

 the trenches of the German- Allies' battle line in northern France (1915) led 

 to the suspicion that infected bullets had been used, until it was found 

 that the old garden and field soils of this region were the prolific sources 

 of the infection. 



In the condition known as boils, acne, carbuncles, furuncles, we have 

 active infection by the staphylococcus and streptococcus groups with leu- 

 cocytic invasion and reaction. There may be infection of the heart (endo- 

 carditis), of the joints (rheumatoid), of the pleurae, of the kidneys and of 

 other organs, especially when the pus organisms gain access to the circu- 

 lation. An extensive local infection (as in marked and prolonged tonsil- 

 litis) may result in the infection of internal organs, often with serious and 

 even fatal results. Localized inflections, as pus pockets in carious teeth, 

 bones, mucous tissues, connective tissues, internal organs, etc., are respon- 

 sible for rise in temperature and many other systemic disturbances. 



Phagocytosis is also marked in living cells outside pf the higher animal 

 organism. For instance the amebas and paramecia are active and even 

 voraceous devourers of bacteria and of yeast organisms. It has even 

 been suggested that an active amebiasis of the human body as in amebic 

 dysenffery of the tropics and in the very common amebic infection of the 

 mouth cavity (pyorrhea, Rigg's disease), the infecting organisms act pri- 



