A Statistical and Experimental Study of Terminal Infections

TH~ recognition of the pal~ played by bacterial infection in the causation of death in chronic diseases has gained in importance with the multiplication of observations upon the occurrence of such infections in human beings, the subjects of chronic diseases of the heart, kidney, liver, and other organs. The data for a proper appreciation of the relation existing between bacterial infection and chronic disease are to be gained less by the clinical observation of cases than by systematic bacteriological examinations at autopsies. The routine study of cases at autopsy by bacteriological methods will not infrequently reveal the presence of pathogenic micro-organisms which were, perhaps, unsuspected during the life of the patient. This fact has been demonstrated repeatedly in the course of the autopsy work at the Johns Hopkins Hospital, where for some time past it has been the practice to make routine bacteriological examinations. Indeed, such examinations have come to be regarded as belonging to the technique of the post-mortem examination. The data which the first part of this paper embodies are taken from the pathological records of the hospital, and represent the results of bacteriological examinations made by Drs. Welch, Councilman, Barker, Blumer, Livingood, and myself. The routine bacteriological examination of ordinary cases is readily made and does not take much time, while the investigation of general, multiple, and mixed infections requires much time and patience: The proper study of cases demands the preparation of cul-