1905.] On Tubercular Infection in a Patient's Blood, etc. 



207 



with respect to the staphylococcus, was taken as evidence that the patient 

 was not infected with tubercle, and that he was infected by staphylococcus, 

 and had responded to that infection by a production of immunising 

 substances. 



The fact that the tuberculo-opsonic index of the fluids obtained from the 

 pus was the same as that of the blood, while the staphylo-opsonic power 

 was only two-fifths of that of the circulating blood, was taken as of con- 

 firmatory evidence of the conclusion already arrived at. The fact that a 

 copious culture of staphylococcus aureus was obtained from the pus, planted 

 out with aseptic precautions at the operation, further confirmed the diagnosis. 



Observation 3. — Case of psoas abscess. Blood from the patient's finger and 

 pus from the abscess were examined. 





Phagocytic counts. 



With a suspension of 

 tubercle bacilli. 



With a suspension of 

 staphylococci. 





2-4 



5 -0 



Fluid obtained from the 



1-23 



1-2 



pus by centrifugalisation 







The fact that the fluid obtained from the pus was impoverished in both 

 tuberculo- and staphylo-opsonic substances as compared with the blood was 

 taken as evidence of a combined infection by tubercle bacilli and staphylo- 

 cocci. This inference was confirmed by the fact that the opsonic power of 

 the blood with respect to both the micro-organisms here in question was 

 undergoing perpetual fluctuations.* The inference so far as it related to the 

 staphylococcus was further confirmed by the fact that cultures of the micro- 

 organism were obtained from the pus. 



Observation 4. — Case of ascites with grave constitutional disturbance in 

 a man of 30. Blood from the finger and ascitic fluid were examined on two 

 occasions. 



First Occasion. 



Tuberculo-opsonic index. 



Serum 1*05 



Ascitic fluid 0'99 



We reported upon this that the patient was not suffering from tubercular 

 peritonitis. 



* For the variations registered in connection with the tuberculo-opsonic power, vide 

 supra, p. 196 of this paper, where Example 3 refers to the patient here in question. 



