560 
DR. BILLINGS. 
“The exanthematous form is by no means so frequent, under 
natural conditions, as the pectoral, and the pathological phe¬ 
nomena go to show that the disease should be generally desig¬ 
nated as an ‘ infectious pneumonia ”* • 
“ As a rule we generally observe the presence of a fibrinous 
pleuro-pneumonia (frequently combined with pericarditis and 
mediastinitis) in varied degree and intensity; often terminating 
in well developed gangrenous pneumonia. The pectoral form is 
less acute than the exanthematous, frequently requiring six days 
before terminating fatally; sometimes it takes on a chronic 
course. This different deportment of one and the same virus can 
only be explained by the different ostia through which it gains 
access to the body; that is, whether by means of the external 
wounds, or the respiratory tract, or as to whether a greater or 
less quantity is taken in exclusively by the lungs, or if the same 
is swallowed with the saliva and thus gains access to the intes¬ 
tines. The fact that we find intestinal 'complications in this 
disease leads me to add an intestinal variety to those already 
mentioned, which has already been done by Kitt, who says: ‘ The 
primary generation of this disease is far more liable to be due to the 
reception of the infectious elements in the intestinal canal, which 
causes a mycosis-intestinalis , than by means of flies, etc.’ 
“ I think that Kitt undervalues the possibility of infection by 
means of the respiratory tract. Bollinger had previously succeeded 
in producing a fatally pectoral form which ended in fifty-four 
hours, by feeding a steer with the contents of the markedly in¬ 
flamed intestine of a calf that perished from the exanthematous 
variety. On the other hand, Bollinger also produced the erysipu- 
latous form by inoculating a cow and a hog with the heart’s 
blood of a calf that had just died of the pectoral variety. The 
hog had at the same time a fibrinous pleuritis in the initial stage, 
and the cow a haemorrhagic gastro enteritis. 
* Here Hueppe contradicts his previous assertion that the disease is ‘ ‘ conta¬ 
gious.” While everybody knows that all contagious diseases must of necessity 
be due to an infecting principle, yet no one would dare claim that peculiar 
clinical forms of one and the same disease, due to one and the same cause, can be 
infectious in the one case and contagious in the other, as Heuppe does in this 
case.—B. 
