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292                 PATHOGENIC BACTERIA.

by Blasi and Russo-Travali it was found that in 26 cases
of pseudoineiiibranous angina due to streptococci, staphy-
lococci, colon bacilli, and pneumococci, 2 patients died,
the mortality being 3.84 per cent. In 102 cases of pure
diphtheria 28 died, a mortality of 27.45 Per cent. Seventy-
six cases showed diphtheria bacilli and staphylococci; of
these, 25, or 32.89 per cent, died. Twenty cases showed
the diphtheria bacilli and Streptococcus pyogenes, with 6
deaths—30 per cent. In 7 cases, of which 3, or 43 per
cent, were fatal, the diphtheria bacillus was in com-
bination with streptococci and pneumococci. The most
dangerous forms met were 3 cases, all fatal, in which the
diphtheria bacillus was found in combination with the
Bacillus coli.

It may be well to remark that all pseudomembranotis
diseases of the throat are not diphtheria, but that some
of them, exactly similar in clinical picture, result from
the activity of the pyogenic organisms alone, and are
neither diphtheria nor contagious.

Diphtheritic inflammations of the throat are not always
accompanied by the formation of the usual pseudomem-
brane, it rarely but occasionally happening that in the
larynx a rapid inflammatory edema without a fibrinous
surface-coating causes a fatal suffocation. Only a bac-
teriological examination will reveal the nature of the
disease in such cases.

Herman Biggs,1 in an interesting discussion of the
occurrence of the diphtheria bacillus and its relation to
diphtheria, comes to the following conclusions:

1.   " When the diphtheria bacillus is found in healthy
throats investigation almost always shows that the indi-
viduals have been in contact with cases of diphtheria.
The presence of the bacillus in the throat, without any
lesion, does not, of course, indicate the existence of the

2.   "The simple anginas in which virulent diphtheria
bacilli are found are to be regarded from a sanitary stand-

1 Amer. Jour, of the Med. Sciences, Oct., 1896, vol. xxii., No. 4, p. 411.