Gangrene as a complication and sequel of the continued fevers, especially in typhoid / by William W. Keen.

  • Keen, William W. (William Williams), 1837-1932.
Date:
[1896]
Catalogue details

Licence: Public Domain Mark

Credit: Gangrene as a complication and sequel of the continued fevers, especially in typhoid / by William W. Keen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    artery and vein. That the bacillus should exist in the pus and in pure culture ought not now to astonish us. The pyogenic power of the typhoid bacilli has been very generally doubted in the past; but, as I shall show here- after, in connection especially with the bone lesions of typhoid, the bacilli have been so frecmently found in pure culture, in abscesses, periostitis, osteomyelitis and other purulent conditions, that we can no longer doubt their oc- casional pyogenic function. If any additional proof were needed, the experimental researches of OrlofF,* Colzi,f and later especially by Dmochowski and Junowski,}: and by Flexner in the paper already alluded to, would dispel any lingering doubt. In Flexner's case, having in mind the objections of E. Fraenkel and Baumgarten, and es- pecially the alleged difficulty of distinguishing between the typhoid bacillus and the colon bacillus, and the belief that all of the abscesses asserted to be from the typhoid bacillus were really the results of mixed infection of the typhoid bacillus and the ordinary pyogenic bacteria, special attention was paid to their differentiation. Inasmuch as the com- monest pyogenic organism, the staphylococcus, has a greater vitality and is more persistent than the typhoid bacillus (cf. p. 67), so that the latter would die out before the for- mer, it is reasonable to conclude that when the typhoid bacilli are found in pure culture in an abscess, they must have been its pathological cause. Why in some conditions the typhoid bacillus should be pyogenic, and in others not, we can only at present .-pecu- late. No reason can be alleged. But we are precisely in the same position as to the pyogenic function of other bacilli, for example the colon bacillus, which we certainly know to be a possible, and one might almost say a frequent cause * Wrntsch, No. 49, 1889, and Nos. 4, 5 and 6, 1890. t Lo Sperimentale, 1890, lxv., 62S. X Ziegler's Beitrilge Path. Anat. ii Allgemcin Pathol., 1895, xvii., 221.