344 ' 
C. M. DAY. 
fact that certain forms of organisms are invariably present, 
staphylococci and streptococci, in acute abscesses, whatever 
share they take in their causation. They enter either through a 
wound, mucous membrane or skin, and travel by means of the 
lymphatics or blood-vessels. 
Staphylococci lead to circumscribed abscesses; streptococci 
spread by the lymphatics and are followed by diffuse suppura¬ 
tion. Suppuration cannot occur without pyogenic organisms 
just as tubercle cannot occur without its specific bacillus. 
When nutrition of the tissues is impaired by prolonged 
residence in foul air, or during convalescence from exhaustive 
disease, suppuration occurs without local injury; the capillaries 
may become plugged with micro-organisms at some point, and 
the walls of the vessels are then the first to perish and melt 
away. Aided by the hypersemic condition of the parts, the 
o-erms remain sufficiently powerful to continue the destruction 
in the direction of least resistance. 
If these germs are slow in their action or do not invade a 
very extensive area, nature tries to protect the system against 
the invading organisms and their ptomaines by throwing a sheet 
of tough fibrous tissue around the pus formed to prevent the 
organisms and their products from entering the general system 
and causing general infection. But, when the streptococci py- 
ogeneus gains early access to the lymphatic spaces and spreads 
through them before the tissues can resist, a resisting membrane 
is never formed and suppuration is diffuse; the tissues are so 
reduced in strength they disappear before the invading germs, 
unable to protect themselves with a barrier of any kind. 
Diffuse suppuration is only met with when the action of the 
germs are very intense, or the resisting power of the tissues is 
exceedingly feeble and is associated with both streptococci and 
staphylococci. Sometimes, owing to the presence of dense 
sheets of fascia, the pus spreads laterally for a distance among 
the tissues, but sooner or later its course turns towards the 
surface, the skin, or mucous membrane, as the case may be, 
gives way and the abscess breaks and discharges its contents. 
