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This is a careful study of the subject of peritonitis of appendiceal origin. The author shows that the peritonitis in these cases is seldom due to a single form of organism and that the mere fact that but one variety of organism grew on the culture medium is no indication that the peritonitis was due to a simple infection. In most of the cases he finds a multiple infection and shows that the reason why they have usually not been found is that they are anaerobic in their nature and thus do not grow under the ordinary cultural methods. Even in those cases seen early with a slightly turbid serous exudate which ordinarily have shown no bacterial growth, which therefore have been termed toxic or chemical peritonitis, he finds anaerobic bacteria of various kinds if suitable cultural methods are employed. Naturally the organisms found are those present in the intestine
Studien ueber die bei Peritonäalen Infektionen Appendi-kulären Ursprungs Vorkommenden Sauerstofftoleranten Sowie Obligat Anaëroben Bakterienformen mit besonderer Berücksichtigung ihrer Bedeutung für die Pathogenese derartiger Peritonitiden.. JAMA. 1910;55(2):152. doi:10.1001/jama.1910.04330020056038
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