PYOGENIC BACTERIA. 387 
dred elements may be found in a single chain, and some of these are distin- 
guished by their size; occasionally whole chains are made up of these large 
cocci, and when closely observed some of these may present indications of 
division transversely to the axis of the chain. Subcutaneous inoculation of 
cultures into mice results in the death of a considerable number of these ani- 
mals—more than half; and the streptococci are found in the spleen and other 
organs. Inoculation into the ear of rabbits causes an erysipelatous inflam- 
mation. When injected into the circulation of these animals through a vein 
joint affections are developed in from four to six days, and a purulent ac- 
cumulation occurs in which the streptococci are found. In two rabbits in- 
oculated in the same way with a culture of the streptococcus of erysipelas, 
Loffler has observed a similar result.” 
Numerous researches indicate that infection by Streptococcus 
pyogenes through the endometrium is the usual cause of puerperal 
fever. Thus Clivio and Monti demonstrated its presence in five 
cases of puerperal peritonitis. Czerniewski found it in the lochia of 
a large number (thirty-five out of eighty-one) of women suffering 
from puerperal fever, but in the lochia of fifty-seven healthy puer- 
peral women he was only able to find it once. In ten fatal cases he 
found it in every instance, both in the lochial discharge during life 
and in the organs after death. Widal carefully studied a series of 
sixteen cases and arrived at the conclusion that this was the infect- 
ing microérganism in all. Bumm and other observers have given 
similar evidence. Hiselsberg and Emmerich have succeeded in de- 
monstrating the presence of the streptococcus in hospital wards con- 
taining cases of erysipelas. That puerperal fever may result from 
infection through the finger of the accoucheur, when he has previ- 
ously been in contact with cases of erysipelas, has long been taught, 
and, in view of the facts above recorded, is not difficult to under- 
stand. But in view of the fact that the streptococcus of pus has been 
found in vaginal mucus and in the buccal and nasal secretions of 
healthy persons, it may appear strange that cases of puerperal fever 
not traceable to infection from erysipelas or from preceding cases 
do not occur more frequently. This is probably largely due to an 
attenuation of the pathogenic power of the streptococcus when it 
leads a saprophytic existence. Widal asserts that, when cultivated 
in artificial media for a few weeks, the cultures no longer have their 
original virulence, and Bumm has made the same observation. On 
the other hand, in ‘‘ streptococcus-peritonitis ” occurring as a result 
of puerperal infection Bumm states that the thin, bright-yellow, 
odorless fluid contained in the cavity of the abdomen is extremely 
virulent ; a very slight trace, a fragment of a drop, injected into the 
abdominal cavity of a rabbit, is sufficient within twenty-four hours 
to cause a general septic inflammation with a bloody serous exuda- 
tion, quickly terminating in the death of the animal ; injected sub- 
cutaneously it gives rise to an enormous phlegmon which also 
