Report on the etiology and prevention of yellow fever . bacilli, carried in tbefirst place by tbe blood current, had effected a lodgment and estab-lished a center of infection in tissues already, perhaps, necrotic, andthrough wbich the circulation bad ceased. Tbe latter supposition seemsto be JListihed by tbe fact that there were comparatively few of these ETIOLOGY AND PREVP^NTION OF YELLOW FEVER. 139 foci, whereas if they had been established while the circulation wasstill going on we would expect to liud numerous secondary foci and acertain number of bacilli iu the neighboring capillary vess
Report on the etiology and prevention of yellow fever . bacilli, carried in tbefirst place by tbe blood current, had effected a lodgment and estab-lished a center of infection in tissues already, perhaps, necrotic, andthrough wbich the circulation bad ceased. Tbe latter supposition seemsto be JListihed by tbe fact that there were comparatively few of these ETIOLOGY AND PREVP^NTION OF YELLOW FEVER. 139 foci, whereas if they had been established while the circulation wasstill going on we would expect to liud numerous secondary foci and acertain number of bacilli iu the neighboring capillary vessels. More-over, there was uo evidence of inflammatory reaction as a result of thisinvasion of the tissues by parasitic organisms. I am, therefore, of theopinion that this is some ordinary saprophyte which had effected alodgment in the kidney, possibly during the last hours of life when thevital resistance of the tissues was slight, or when, as a result of theblood stasis in the organ, local necrosis had already occurred at certainpoints before Fig. 6.—Collection of straight bacilli in glomerulus, yellow fever kidney. Material from Havana. It is quite probable that during the last hours of life a certain num-ber of microorganisms from the intestine succeed in passing throughthe enfeebled tissues to the interior of the capillaries, and are carriedaway by the already slowly moving blood stream to distant organs,where they may establish centers of growth even before death occurs,or are at least in position to take possession of the field as soon as thevital spark has been extinguished. In the case in question I believethat the true explanation of the presence of the organisms described isthat suggested, for I have not found in the other cases examined anysimilar collection of bacilli, and can not therefore attach any importanceto the observation so far as the etiology of yellow fever is Berlin I fell upon a little group of minute, slender bacilli, in a capil-
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