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280 THE MICRO-ORGANISMS OF THE HUMAN MOUTH.
and a slight amount of albumen in the urine, were noted. The
region of the angle of the lower jaw on the left side was slightlj'
reddened, hard, swollen, painless, without fluctuation; on the
inner side greatly swollen, reddened, and hard. The wound was
filled with stinking, discolored matter, which discharged in mi-
nute quantities when the gums were pressed. The neighboring
lymphatic glands swollen, the spleen greatly enlarged. In the
left lower pulmonary region, marked exudation and increased
respiratory murmur; cough with thin, stinking expectorations,
which contained many pus-corpuscles and streptococci. Inter-
mittent fever appeared, and finally death ensued under convul-
sions.
The autopsy revealed septic phlegmon of the entire left side
of the inferior maxilla and neck, with ichorous periostitis of the
aflected jaw, cachectic pneumonia of the left lower pulmonary
lobe, and a great number of metastatic abscesses in both lungs,
further ichorous pachymeningitis of the dura mater, covering
the left sphenoid and temporal bone, with ichorous thrombi of
the corresponding sinus cavernosus, intercavernosus, and petro-
sus superior.
" In this case the infectious process, probably caused by an un-
clean instrument, had begun at the infected wound of the jaw
and then continued to spread from the roots of the vena submen-
talis, sublingualis, pharyngea to the plexus pterygoideus and
ophthalmicus, and through the superior sphenoidal fissure to
the sinus of the brain."
Another case which belongs to this group of infectious dis-
eases occurred in the surgical clinic of von Mosetig-Moorhof,
and has been reported by von Metnitz.^^
A woman, fortj'-three years old, who had had several teeth
extracted a week previously, was brought to the Vienna Hos-
pital in an unconscious condition. A few days after the extrac-
tion she had fallen ill, sufiering from continual pain and chills.
Three days before her admission delirium, psychical disturb-
ances,-and one day before, total loss of consciousness had ensued,
i^othing could be ascertained as to any former complaint.
The scalp was considerably swollen, also the left cheek and the
malar and temporal regions. The skin of these parts was pale,