226 MODES OF ACTION. 
three weeks and five days after the first inoculation. At the autopsy 
‘“‘the lymphatic glands of the inguinal and axillary regions were 
found to be enlarged and reddened; the cervical glands were swollen 
and the thyroid gland was greatly congested. There was a consider- 
able excess of clear fluid in the peritoneal cavity. Both layers of the 
peritoneum were reddened, the vessels of the visceral layer being es- 
pecially injected. The spleen was enlarged to double the average 
size; it was mottled, and the white follicles were distinctly outlined 
against the red ground. The liver was dark in color and contained 
much blood. . . . The kidneys were congested and the cut surface 
was cloudy. . . . The pericardial sac was distended with clear se- 
rum. Under the epicardium were many ecchymotic spots. The 
lungs exhibited areas of intense congestion or actual haemorrhage 
into the tissues. . . . The histological lesions in this case are identi- 
cal with those observed by us in connection with the inoculation of 
the living organisms.” 
To what extent non-specific catarrhal inflammations of mucous 
membranes are caused by the local action of microédrganisms has 
not been determined, but in gonorrhcea the proof is now considered 
satisfactory that the ‘‘ gonococcus” of Neisser is the cause of the 
intense local inflammation and purulent discharge. In this disease 
the action of the pathogenic microérganism seems to be limited to 
the tissues invaded by it, as there is no general systemic disturbance 
indicating the absorption of a toxic ptomaine. 
Chronic catarrhal inflammations appear, in some cases at least, 
to be kept up by the presence of microédrganisms, which are always 
found in the discharges from inflamed mucous surfaces. 
The influence of microédrganisms, and especially of the pus cocci, 
in preventing the prompt healing of wounds, is now well established. 
An extensive suppurating wound or collection of pus, especially if 
putrefactive bacteria are present, causes fever and nervous symp 
toms, due to the absorption of toxic products. More intense general 
symptoms result from the presence of the streptococcus of pus than 
from the less pathogenic staphylococci ; this is seen in erysipelatous 
inflammations and in puerperal metritis due to the presence of this 
micrococcus. Like the other pus cocci, the Streptococcus pyogenes 
does not usually invade the blood, but when introduced into the sub- 
cutaneous tissues it induces a local inflammatory process, with a ten- 
dency to pus formation, and it invades the neighboring lymph chan- 
nels, in which the conditions appear to be especially favorable for its 
multiplication. 
Finally, certain pathogenic bacteria, when introduced into the 
bodies of susceptible animals, quickly invade the blood and multiply 
in it. Inso doing they necessarily interfere with its physiological 
