Studies in cardiac pathology . ccus. Culturally theformer organism showed distinct differences from the type whichordinarily causes pneumonia. The origin of infection was asfollows: Pneumonia 1, tonsillitis 2, alveolar abscess 2, influenza 1,no discoverable cause 8. We are thus gradually coming to realizethe fact that relativelj unimportant infections of the nares, naso-pharynx, ears, mouth, gums, etc., may be the portal of entrancefor the most severe of endocardial inflammation. As has been intimated, pneumococcus endocarditis is apt tobe rapidlj^ fatal. Acute cases do not usually last
Studies in cardiac pathology . ccus. Culturally theformer organism showed distinct differences from the type whichordinarily causes pneumonia. The origin of infection was asfollows: Pneumonia 1, tonsillitis 2, alveolar abscess 2, influenza 1,no discoverable cause 8. We are thus gradually coming to realizethe fact that relativelj unimportant infections of the nares, naso-pharynx, ears, mouth, gums, etc., may be the portal of entrancefor the most severe of endocardial inflammation. As has been intimated, pneumococcus endocarditis is apt tobe rapidlj^ fatal. Acute cases do not usually last over threemonths, although Frankel has reported a case of pneumococcusendocarditis lasting six months.^ In Rosenows experimentsthe lesions were generally progressive, though healing did states that a close relationship exists between the biologiccharacters of the bacteria and their abihty to produce endo- Statistics collected by the author. - Billings; Arch. Int. Med., 1909, iv, No. 5. Frankel: Deut. med. Woch., Fio. 7.—Acute Infective aortic leaflets are thickened, shriveled, perforated, and show extensive ulcerativetissue destruction with little thrombosis. Beneath the aortic leaflets the ulceration is begin-ning to extend downward toward the mitral valve. 20 STUDIES IN CARDIAC PATHOLOGY carditis in the class of cases observed. The bacteria isolated,while having little or no pathogenic power to animals, andbeing susceptible to phagocytosis, present definite evidence ofbeing immunized against the antibodies of the individual host,thereby perhaps overcoming the resistance of the latter. In a series of cases of pneumococcus endocarditis studied byRosenow^ the mitral and tricuspid valves were mostly diseased,a state of affairs which he attributes to the presence of capillariesin these valves favoring embolism. The exact distribution in Prebles cases of endocarditis inpneumonia was as follows: Per Cent. Aortic only 56 Mitral only 40 Aor
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