Study of the Bacteriolytic Serum-Complements in Disease: a Contribution to our knowledge of Terminal and other Infections

Abstract

It has long been known that individuals who suffer from such chronic diseases as nephritis and cirrhosis of the liver are very liable to develop an acute infection during the last stages of their illness. These patients rarely die of their chronic ailment. Often in the very last days, or perhaps hours, of the disease pneumonia, a dysentery, an acute endocarditis, or a streptococcus infection sets in, which quickly terminates fatally and must be regarded as the immediate cause of death. So familiar is this course of events that such pneumonias or dysenteries are now known as a fairly definite group of infections, namely, terminal infections. Often they are not recognized before death, but at autopsy their frequency and varying characters have been well shown by Flexner in his statistical and experimental study upon the subject; and though in some cases of terminal septicaemia the portal of entry was not easily found, yet it is important to note how frequently such local infections as leg ulcer or tonsilitis served as a starting point for the general invasion of bacteria. Of still more importance are his observations upon the bactericidal action of the blood of patients who have chronic diseases. The serum from six out of nine such patients showed a distinct decrease in its destructive power toward the Staphylococcus aureus and two of three patients whose serum did not show a diminished bactericidal action left the hospital improved.