386 PYOGENIC BACTERIA. 
around the point of inoculation after a period of incubation of from 
fifteen to sixty hours, This was attended with chilly sensations and 
an elevation of temperature. Persons who had recently recovered 
from an attack of erysipelas proved to be immune. 
Sections made from the ear of an inoculated rabbit, or of skin taken 
from the affected area in erysipelas in man, show the streptococci in 
considerable numbers in the lymph channels, but not in the blood 
vessels. They are more numerous, according to Koch and to Fehl- 
eisen, upon the margins of the erysipelatous area, and may even be 
seen in the lymph channels a little beyond the red margin which 
marks the line of progress of the infection. 
The researches of Weichselbaum and others show that Strepto- 
coccus pyogenes is the infecting microorganism in a certain propor- 
tion of the cases of ulcerative endocarditis. The author named 
found it in four cases out of fifteen examined, and in two cases of 
endocarditis verrucosa outof thirteen. In a previously reported series 
of sixteen cases (fourteen of ulcerative endocarditis and two of ver- 
rucosa) the streptococcus was found in six. 
In diphtheritic false membranes this streptococcus is very com- 
monly present, and in certain cases attended with a diphtheritic exu- 
dation, in which the Bacillus diphtheriz has not been found by com- 
petent bacteriologists, it seems probable that Streptococcus pyogenes 
is the pathogenic microérganism responsible for the local inflamma- 
tion and its results. Thus in a series of twenty-four cases studied by 
Prudden in 1889 the bacillus of Léffler was not found, “but a strep- 
tococcus apparently identical with Streptococcus pyogenes was found 
in twenty-two.” Chantemesse and Widal have also reported cases 
in which a fibrinous exudate resembling that of diphtheria was as- 
sociated with a streptococcus. ‘‘ These forms of so-called diphtheria 
are most commonly associated with scarlatina and measles, erysipe- 
las, and phlegmonous inflammation, or occur in individuals exposed 
to these diseases ; but whether exclusively under these conditions is 
not yet established ” (Prudden). 
Léffler has described under the name of Streptococcus articu- 
lorum a micrococcus obtained by him from the affected mucous 
membrane in cases of diphtheria, and which he believes to be acci- 
dentally present and without any etiological import in this disease. 
In its characters it closely resembles Streptococcus pyogenes and is 
perhaps a variety of this widely distributed species. Its characters 
are described by Fligge as follows : 
“Cultivated in nutrient gelatin, it forms at the end of three days small, 
transparent, light-gray drops, upon the margin of which, under the micro- 
scope, the cocci in twisted chains may be observed. As many as one hun- 
