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It should be added, however, that the contagiousness of inherited syphilis is denied by some observers, who affirm that, when syphilitic infants prove infective, the disease has been really acquired at or soon after birth.
#Clinical Varieties of Bacillary Gangrene.# #Acute infective gangrene# is the form most commonly met with in civil practice. It may follow such trivial injuries as a pin-prick or a scratch, the signs of acute cellulitis rapidly giving place to those of a spreading gangrene.
It is probable that the decomposition of the contents is the result of the presence of bacteria, and that from the surgical point of view they should be regarded as infective. A sebaceous cyst may remain indefinitely without change, or may slowly increase in size, the skin over it becoming stretched and closely adherent to the cyst wall as a result of friction and pressure.
A splinter driven underneath the nail causes great pain, and if organisms are carried in along with it, may give rise to infective complications. The free edge of the nail should be clipped away to allow of the removal of the foreign body and the necessary disinfection. Trophic Changes. The growth of the nails may be interfered with in any disturbance of the general health.
The differential diagnosis is often difficult, especially in the chronic nodules, in which it may be impossible to demonstrate the bacillus. The ulcerated lesions of farcy have to be distinguished from those of tubercle, syphilis, and other forms of infective granuloma. Treatment. Limited areas of disease should be completely excised.
Indeed, Koch thinks that the admixture of sulphate of iron with fæcal matter may arrest putrefaction, and really remove what may be the most destructive process to the comma bacilli. Hence he would distinguish between substances which merely arrest putrefaction and those which are bactericidal; for the former may simply serve the purpose of preserving the infective virus.
Those sustained in the open, long-range fighting of the South African campaign of 1899–1902 were very different from those met with in the entrenched warfare in France in 1914–1918. It has been found also that the infective complications are greatly influenced by the terrain in which the fighting takes place.
And next came the bold pronunciamento of no less an authority than Koch himself, that the bovine bacillus also was so feebly infective to human beings that it might be practically disregarded as a source of danger. This promptly split the bacteriologists of the world into two opposing camps, and started a warfare which is still being waged with great vigor.
It would perhaps be better to consider a slow-going inflammatory process subsequent to acute endocarditis as a subacute endocarditis; and an infective process may persist in the endocardium, especially in the region of the valves, for many weeks or perhaps months, with some fever, occasional chills, gradually increasing valvular lesions and more or less general debility and systemic symptoms.
The infection of all these diseases is communicable through the air, and where there is overcrowding, the chance of being infected by infective particles, given off by the breath or skin, is of course very great. Where there is overcrowding, the collections of putrescible filth are multiplied, and with them probably the productive foci of infective particles.
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