I950 DISEASES OF THE GENERATIVE SYSTEM 



first is the autogenous, caused by organisms, like 5. pufridus, which 

 lives in the normal vaginae of pregnant and puerperal women, and 

 are capable of being carried from the vagina to the uterus by means 

 of instruments or by the hand. This form he considers to be non- 

 contagious. 



The second method of infection is the heterogeneous, caused by 

 5. erysipelatos , and brought from an external source of infection 

 to the puerperal woman as just described. 



Von Lingelsheim, in 19 12, considered that the importance of 

 S. putridus must, for the time being, remain undecided, as it lacked 

 confirmation, but it is obvious that the gas production alone differen- 

 tiates this streptococcus from 5. erysipelatos Fehleisen, and it 

 appears to us that there is a general agreement between Schott- 

 miiiler's organism and that described by Veillon. They both 

 produce foetid gas, they both are obligatory anaerobes, and they are 

 both found in the vagina and also in association w ith puerperal fever, 

 and they have both been found in severe infections in other parts of 

 the body. They are probably the same organism as the anaerobic 

 vaginal streptococcus described by Menge and Kroenig, and also 

 that found by Gioelli in 1907. 



All these organisms, in our opinion, should be classified under 

 the name of S. fcetidus Veillon, 1893. 



In 1901 Lewkowicz found an obligatory anaerobic streptococcus, 

 which he named 5. anaerohius micros, in the mouths of sucklings. 

 In 1907 Jeannin reported that it was present fairly frequently in 

 puerperal infections. It is described as being lanceolate and usually 

 disposed in diplococcal forms, and only occurring in short chains. 



In 1812 Furneaux-Jordan published an important lecture upon 

 'Puerperal Infection.' He and Mackay examined the uterine 

 discharges of twenty-one cases of puerperal fever, and found strepto- 

 cocci in seventeen cases — i.e., 80 per cent. This streptococcus was 

 identical in all cases, and was said to be quite distinct from other 

 streptococci, and so the name Streptococcus puerperalis Furneaux- 

 Jordan and Mackay, 1912, was given to it ; but we have noted that 

 Arloing had already applied this name in 1884 to a streptococcus 

 which he obtained from cases of puerperal fever, and which he 

 believed to be distinct from S. erysipelatos and S. pyogenes, the only 

 named forms at that time, but at present all three are considered 

 to be one and the same organism. 



In 1916 Chalmers and Atiyah found that S. salivarius, S. bovis 

 (synonym, S. hovinus), and S. versatilis, were causal germs in the 

 Anglo-Egyptian Sudan, and traced the origin of these germs to 

 human saliva (5. salivarius), zibla — i.e., horse-dung used for walls 

 and floors — ^bovine faeces, and equine faeces, etc. (S. hovis and S. 

 versatilis) . 



^ The known puerperal streptococci are therefore: — • 

 K I. 5. erysipelatos Fehleisen, 1883. 



2. S. fcetidus Veillon, 1893. 



3. S. anaerohius Lewkowicz, 1901. 



