57 
Vegetative Endocarditis. 
Last year we noted in the report that six cases of endo- 
carditis had been observed. Four of these were among 
opossums and now to this number we can add three. 
These animals all came from the same cage, but were not 
all of the same lot, being successive acquisitions. The 
appearance of seven cases of this disease in the same 
species of animals is interesting and instructive. The 
causative organism in three cases was a pure culture of 
streptococcus. In another this was combined with a 
capsulated fermenting bacterium very infrequent in such 
vegetations but common enough in the intestine. It was 
therefore probably a post mortem invader. The cases 
varied but little so far as the heart was concerned. The 
left side was involved in all. The vegetations varied 
from an acute soft fragile exudation to a large firm cauli- 
flower mass. One case showed cicatricial contraction 
with very small vegetations. The first was apparently 
the origin of dissemination of the poison throughout the 
body, for evidences of septicemia of varying grades were 
frequently present. Petechial hemorrhages and throm- 
boses were common. In one of these acute cases an 
arthritis was found, not a very uncommon thing in 
streptococcus septicemia. Then we have the type of 
firm cauliflower-like vegetation assocaited with less 
violent signs of acute disease. These are simply longer 
developments of the first type. The general pathology 
shows a prolonged poisoning with subacute or even 
chronic inflammations in the kidneys and liver. Com- 
pensation is seldom lost, although this is difficult to ex- 
plain when we consider that usually after death the 
aortic valve aperture will scarcely permit the passage 
of a hair. The mitral has also been nearly tight. Never- 
theless no noteworthy hypertrophy of chamber walls has 
occurred. A few animals showed a mild passive conges- 
tion of lungs and liver, so that blood pressure changes are 
not completely adjusted. The heart muscle has shown 
