trefaction.
Osteomyelitis is of greater severity, it is believed, if due to a
mixed infection with both the white and golden grape-coccus of
suppuration.

I have previously mentioned that the bacteria of malignant pustule are
powerless to do harm when the germs of erysipelas are present in the
tissues and blood. This is an example of the way in which one species
of bacteria may actually aid the white cells, or leucocytes, and the
tissues in repelling an invasion of disease-producing microbes.

Having occupied a portion of the time allotted to me in giving a crude
and hurried account of the characteristics of bacteria, let me
conclude my address by discussing the relation of bacteria to the
diseases most frequently met with by the surgeon.

Mechanical irritations produce a very temporary and slight
inflammation, which rapidly subsides, because of the tendency of
nature to restore the parts to health. Severe injuries, therefore,
will soon become healed and cured if no germs enter the wound.

Suppuration of operative and accidental wounds was, until recently,
supposed to be essential. We now know, however, that wounds will not
suppurate if kept perfectly free from one of the dozen forms of
bacteria that are known to give rise to the formation of pus.

The doctrine of present surgical pathology is that suppuration will
not take place if pus-forming bacteria are kept out of the wound,
which will heal by first intention without inflammation and without
inflammatory fever.

In making this statement I am not unaware that there is a certain
amount of fever following various severe wounds within twenty-four
hours, even when no suppuration occurs. This wound fever, however, is
transitory; not high; and entirely different from the prolonged
condition of high temperature formerly observed nearly always after
operations and injuries. The occurrence of this "inflammatory,"
"traumatic," "surgical," or "symptomatic" fever, as it was formerly
called, means that the patient has been subjected to the poisonous
influence of putrefactive germs, the germs of suppuration, or both.

We now know why it is that certain cases of suppuration are not
circumscribed but diffuse, so that the pus dissects up the fascias and
muscles and destroys with great rapidity the cellular tissue. This
form of suppuration is due to a particular form of bacterium called
the pus-causing "chain coccus." Circumscribed abscesses, however, are
due to one or more