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Babes has always found the streptococcus in in- flammatory products secondary to scarlet fever. Heubner and Bahrdt, in a fatal case diflucan compresse costo of scarlet fever, complicated with suppuration of the finger and knee joints and pericarditis, found a streptococcus identical with the Streptococcus pyogenes. Frankel and Freudenberg obtained cultures of cocci from the submaxillary lymph glands, spleen, liver, and kidneys. These could not be distinguished from the Streptococcus pyogenes found in pus, nor from the iden- tical streptococcus frequently cultivated by Frankel in large numbers from puerperal infection. In two of the eases, as the streptococcus was the only organism found, they generic diflucan no prescription concluded that the presence of the streptococcus was due to the secondary infection diflucan costo which was laid open by the lesion in the throat, and that the true scarlatinal contagium was probably present on the skin. Euskin, Holmes, and Crookshank hold this view also, and maintain that the nature of the contagium of scarlet fever is unknown. Klein regards this generic diflucan cost streptococcus as the actual cause of scarlet fever. Hence the whole setiology simmers down to strepto- mycosis, or staphylo-mycosis, with probably an occa- sional gonococcus or colon bacillus. This latter, some authorities think, begins in the colon, the colon bacillus subsequently penetrating the walls of the colon and gaining access to the uterus. It is interesting to mark the developments, but lam- entable that they have not diflucan cost with insurance been in generic diflucan 150 mg more rapid suc- cession. Oliver Wendell Holmes, in his masterly paper, drew attention to the infectious character of puerperal fever. Semmelweise, in 1846, observed that decompos- ing organic animal matter produced septicaemia. The attention of the profession has from time to time been drawn to the danger of erysipelas, scarlet fever, diph- theria, etc., to the parturient woman. But it was not until 1886 that Pasteur discovered the streptococcus in puerperal septicaemia. To pfizer diflucan costo the bacteriologists are we indebted largely for having caused the obstetric pendu- lum to swing from the domain of medicine to the do- main of surgery, where it justly belongs. But, for the immense reduction in the mortality and morbidity of these cases are we indebted to the Eight Hon. Lord Lister, who above all, in antiseptics at least, stands proudly eminent. For, as I have already said, antiseptic surgery means antiseptic midwifery, and the neglect of any of its diflucan cost without insurance details is as unpardonable in the diflucan gel costo one as the other. Semmelweise apparently shot over the heads of his colleagues some thirty or forty years when he made the statement that the decomposing organic animal matter which, when introduced, produced diflucan 150 mg costo childbed fever was in the vast majority of cases brought to the patient from without. At first sight one would think that this is, practically, the view held by bacteriologists to-day, there being only a change in the phraseology — that is, for " decomposing animal matter " they substi- tute pyogenic organisms — but this is not strictly cor- rect, for we how much diflucan cost know, as a matter of fact, that cadaveric poison may contain pyogenic organisms, diflucan 150 costo or it may con- tain simply generic diflucan fluconazole saprophytes, this depending largely on the cause of death and the time that has since elapsed, so that the physician may go from one autopsy to a labor case with comparative safety, while from another he buy generic diflucan online might convey a most virulent poison. Yet it is ques- tionable if the introduction of decomposing organic animal matter, whether it contained pyogenic organ- isms or not, might not produce septicaemia in the par- turient woman by re-enforcing attenuated pyogenic or- ganisms diflucan cost which may already be present in the parturient canal. As we know that the mere presence of pyogenic organisms in a wound is not sufiicient to produce septi- caemia, as they have frequently been found in wounds in which there has been found no suppuration, it follows that something more discount diflucan is necessary; yet what this some- thing is we do not quite know, but we do know that decomposing animal matter, decomposing clot, a piece of membrane or placenta, all form a favorable medium for bacteria to develop in. The fact that some other agent than the mere presence of pathogenic organ- isms is necessary for the production of infection has been shovra by Bossowski (9), and costo del diflucan more recently by Welch (10) and Howard, who introduced virulent cul- tures of generic diflucan over counter the staphylococcus into the fresh blood clot of 704 HASTIN6S: SEPTICEMIA IN TEE PUERPERIUM. [N. y. Med. Jocr., generic diflucan online wounds antiseptieally treated without producing suppu- ration. The same has been noticed in the puerperal uterus.

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