.0 -^^o^ .^ .^^ .0^ ^. V" <^ ,0^ ^Q-n^ , .:5°<. - ^ %;^^^ .^ -^ -.^ >> .^ ^ .^ o <. " .^' *^' .-u '5' 0' V \^ ^" : P /"^.^'mm ,0^% ^^^^ /^. '^«> .^^ • • > * > THE BACTERIOLOGY OF THE FEMALE REPRODUCTIVE ORGANS OF CATTLE AND ITS RELATION TO THE DISEASES OF CALVES A THESIS PRESENTED TO THE FACULTY OF THE GRADUATE SCHOOL OF CORNELL UNIVERSITY FOR THE DEGREE OF DOCTOR OF PHILOSOPHY BY CHARLES M.' CARPENTER Reprinted from the Annual Report of the New York State Veterinary College at Cornell University, Ithaca, N. Y., 1920-1921 X-.M s >THE BACTERIOLGY OF THE FEMALE REPRODUCTIVE ORGANS OF f CATTLE AND ITS RELATION TO THE DISEASES OF CALVES Vr) Chaeles M. Cabpenteb 5^ Department of Pathology and Bacteriology CyNew York State Veteiinary College at Cornell University, Ithaca, N. Y. ~^}-^ Perhaps the most important diseases in animal pathology, or those receiv- (;^ng the most attention at least at the present time, are the pathological con- ditions associated with the breeding of cattle. From a study of the reproduc- ' rtive efficiency in many large herds, Williajns (1) has found that it is about 60 per cent of the ideal. The ideal which he considers normal and which herds, especially dairy herds, should strive to attain, is that each female in the herd should produce one living calf every twelve months, and that each heifer throw her first calf at two years of age. The U. S. Department of Agriculture placed the losses from observed contagious abortion at $20,000,000 for the year 1915 (2). A conservative estimate of all losses from infections associated with the breeding of cattle is 25 per cent, and since the valuation of all the cattle in the U. S., as reported January 1, 1921, is $1,934,185,000 (3) one can readily judge the enormous economic loss to the country. Moreover great losses are caused by these diseases in connec- tion with the work of improving the breeds and from a scientific point of view, by reason of the breaking up of experiments in heredity. The importance of the ))acterial content of the genital canal can easily be estimated from the foregoing statements. Much confusion has arisen in the past, and still exists, inasmuch as many observers in this field have studied the infections occurring in the diseased conditions without any knowledge of the microorganisms that may txist in the healthy reproductive organs of cattle. This is true of almost all the diseases that have been under close ■ observation because it is primarily the abnormal condition that attracts the attention of the investigator. Because of the widely varied opinions concerning the different miccoorgan- isms existing in the reproductive (jrgans and their relation to the etiology of the diseases associated with them, it has seemed advisable to make a thorough bacteriological investigation of these organs, covering all ages and conditions, in an effort to improve the general conception of this subject and to correlate the facts with more accuracy. This work, started in the fall of 1917, has been carried on systematically and in great detail for nearly four years. In it I have tried to determine six things: First, what micro- organisms, if any, normally live in the organs comprising the female genital tract of cattle? Second, at what age of the animal and by what channels do the organisms enter the genital canal? Third, what relationship exists between these microorganisms and the pathological changes associated with them? Fourth, what effect is produced by these organisms on the fetus in the pregnant uterus, or on the calf at birth? Fifth, is there any evidence that bacteria which may have been transmitted to the calf from the dam lie dormant in the former until breeding age? Sixth, if these bacteria do persist until breeding age, is their habitat the genital tract or do they become localized elsewhere in the body thence proceeding to the reproductive organs st puberty and first pregnancy? History In reviewing the literature dealing with the bacteriology of the female genital tract of man and animals, one can find in human and veterinary medi- cine very little work which has been done upon these diseased tissues. As a result of the losses from puerperal fever in women, when aseptic methods were not understood and observed as carefully as they should have been, special attention was paid to the bacterial flora and chemical reaction of the vaginal secretions of pregnancy and non-pregnancy. The relation of the microorganisms found to the etiology of puerperal fever has been discussed at great length. Chief among the workers have been Doderlein (4), Williams (5), Kronig (6), Winter (7), Bensis (8), Bergholm (9), Walton and Medalia (10), Kiister (11) and Permar (12). These men did not agree entirely in their conclusions but in the main they found that in women the normal vaginal secretion is acid, as tested out with litmus paper, and because of this acidity very few bacteria are capable of living in the vagina. Doderlein reports that the acidity is due to a microorganism whicli lie lias described and which is called Doderlein's bacillus. He carried on experiments with this organism to prove the point but some of the other worl^ers did not agree with him. These men also stated that when the secretion contains large numbers of leucocytes, squamous epithelial cells, and bacteria, they consider it pathological. Under these conditions the reaction of tlie vaginal content approaches the neutrality point and in some cases it even becomes alkaline, in which case the bacteria are able to thrive. Kronig examined 300 cases and reported that the reaction of all these secretions was acid and tliat tliere were no streptococci present. He stated tliat this was the result with the patho- logical as well as with the normal secretions. Besides the gonococcus, the organisms found were for the most part streptococci, staphylococci, the thrush fungus (Oidium albicans) and occasionally a few rods. Sometimes they were found to be pathogenic for laboratory animals, but they often pro- duced no effect upon them and because of this fact some of the investigators considered the organisms to be in a state of low virulence. The streptoco- coc«us was thought to be most important because of its close relation to puer- peral fever. I have come across no systematic bacteriological studies on the flora of the upper part of the healthy genital canal of women, although some work has been done on the bacteriology of cervicitis, endometritis, salpingitis and ovaritis by Rosenow (13), Davis (14), Miller (15), Grad (16), Curtis (17) and Tweedy (18). In veterinary medicine even less work has been done on the bacterial flora of the reproductive organs of domestic animals than can be found in the literature having to do with human medicine. There has been an abundance of material, both normal and abnormal, contrary to the conditions found in human medicine, but no one has availed himself of the opportunity. Because of great losses of calves from various calf infections, some work has been done with the bacterial content of the vagina* of cattle, inasmuch as some of the early investigators believed that the calf became infected during the process of parturition. In 1904 Denzler (19) did considerable work on the bacteria commonly found in the vaginae of cattle and also some bacteriological work on the entire genital tract. He recorded staphylococci, streptococci and organisms from the colonaerogenes gi-oup in the vaginal vestibulum but stated that these bacteria are not able to grow within the healthy vagina. He con- sidered the external os uteri as the normal barrier between the germ-free zone in the genital canal and the zone which harbors bacteria, if, under abnormal conditions, the vagina contains bacteria. After a long series of experiments he concluded that the vaginae of calves, pregnant and non-preg- nant cows possess a power to disinfect themselves if microorganisms acci- dentally enter or are introduced therein. Experimentally he found this bac- tericidal action to l)c permanent, taking the tissues from 18 to 117 hours. He was of the opinion that the leucocytes, acting as phagocytes, and not the chemical reaction of the vaginal secretion, are the agents which destroy the bacteria. He stated further that the cervical canal, the uterus and the tubes are normally free from germs. In 1919 Giltner and Bandeen (20) compared the bacterial findings from ten puerperal uteri with those from the meconia of calves from the same uteri. They say, '" Thirty-four organisms were isolated from the A'aginae and twenty-four from the uteri. There were fifty-two different organisms isolated, only five of which occurred in both uterus and vagina. There were no two cows which showed an identical flora in either uterus or vagina, and there was very little similarity in the bacterial flora of any two cows, although they were all on the same premises ***** " Of the organisms found there Avere, of the four genera according to Migula, bacterium, 22: bacillus, 3: micrococcus. 11; streptococcus, 4." The bacteriology of the fetus and newborn infant is not uniform. It has not been carried out methodically in most cases and the investigator in human medicine has had access in the newborn infant only to tliose cavities which communicate with the exterior from which to make cultures. These cavities are the mouth, rectum and vagina. VonReuss (21) states that staphylococci are invariably present in the infant's mouth when they are present in the vagina of the mother. The streptococci are less frequently found. Kneise (22) reached the conclusion that 100% of infants are born with bacteria in the mouth and that Stajihylococcus aureus greatly predominates over the streptococcus. Knapp (23) reported finding a close relation between the bacterial flora of the vagina and intestine of the newborn. Schmidgall (24) found that in most cases the buccal cavity was free from bacteria for the first 24 hours, although in a few cases she found hemolytic streptococci in the child's mouth as well as in the vaginal secretion of the mother during labor. She concluded that the vaginal flora in the newborn female depends upon the vaginal flora of the mother. The French investigators, Bonnaire, Keim, Jeannin and others, quoted by Mme. Brailowsky -Lounkevitch (25), reported that the buccal fluid of the newborn is sterile. Smith (26) found staphylo- cocci and streptococci in the vaginae of infants at a very early period after birth. The results of the work of Hymanson and Hertz (27) on the bacteri- ology of the partiirient vagina and the mouth and rectum of the newly boin are practically the same as those of the French workers. Various investigators have cultured the meconia of infants and have reported conflicting results. Some have found that the meconium is negative at birth, while others have isolated numerous bacteria. Very little detailed bacteriology has been carried out on the fetuses of domestic animals. The greatest amount of this work has been done on the bovine fetus and is com- paratively recent. When Bang (28) in 1896 flrst described the organism which is now called Bacterkmi abortum, he reported finding it in the tissues of the fetus. Besides a group of fetuses from which Smith (29) isolated Bacterium abortum, he mentioned three other groups, ''(a) the few fetuses yielding sterile cultures, (b) those yielding rapidly growing cultures of colon-like and other bacteria, and (c) those yielding pure cultures of a spirillum." Practically all of the work on bovine fetuses mentioned above has been carried out on fetuses expelled prematurely or dead. I have found almost no literature dealing with the bacteriology of the genital tracts of either the healthy or diseased fetus. Teohnic The technic which I have used in this work has been varied greatly during the four years. Practically every method of isolating microorganisms has been tried and very many different media have been experimented with. My main object has been to improve the technic, i. e., to make it less complex, to decrease errors from contaminating bacteria, and to find the best media upon which the largest number of organisms will grow. In any case many errors will arise and it is almost impossible to interpret results in precise terms. With the exception of the material obtained from the abattoir, all has come from herds located in six of the eastern states. The genital tracts from the cows and veal calves were removed in the following manner: After the animal was slaughtered and skinned, the posterior parts were elevated about four or five feet above the floor. An incision was made along the Unea alba. to allow the abdominal viscera to escape, after which the si/mphi/'Sis pubis was sawed through. An area around the genital tract was flamed with a gasoline torch. Then an incision was made through the recto-vaginal pouch and other folds of peritoneum between the rectum and vagina, four or five inches ante- rior to the vulva. A stout cord was passed through the incision around the vagina and tied securely. An assistant pulled centrally on the cord while all of the attachments of the genital tract were severed with a sterile knife and wrapped immediately in a sterile towel. In some cases, when an assistant was not at hand, the vulva was grasped with a pair of Bozeman's forceps, or other long forceps, held in the left hand, while the attachments were being severed. The only time that the genital organs came into contact with the hands or other possible infection carrier was when the cord was placed around the walls of the vagina and during the exposure for a very short time to the bacteria of the air before wrapping in the sterile towel. The tracts were then taken to the laboratory where cultures were made, smears of the different parts made on glass slides, and sections of the ditlerent organs taken for pathological study. Cultures were made from the ovaries, oviducts, right and left uterine apices, body of the uterus, cervix, and in most cases from the vaginal folds around the external os uteri. The mammary gland was cultured in many cases. About forty cultures were made from each adult genital tract. Four cultures were made from each part. At lirst two aerobic and twu anaerol)ic cultures were made, but later cultures grown at partial oxygen tension were made because no strict anaerobes were recovered. The ovarian cysts and cystic corpora lutea were cultured with a sterile, sharjj-pointed pipette which was pushed through the cyst wall after an area on the latter had been sterilized with a heated platinum spatula. As a rule the cultures from the cystic tluid were negative and_because of this Rosenow's (30) tissue crusher was used to crush tlie whole ovary or as large a section of it as could be placed in the crusher. Cultures were then made from the material that was ground up. This method is inconvenient for crushing cows' ovaries because the ovaries, especially those which are diseased, are too large as a rule to be placed in the crusher without sectioning and it is difficult to handle them so much with- out contamination. The simplest plan is to sterilize an area on the surface of the ovary with a heated platinum spatula, and with a tine pair of sterile forceps to tear out a small piece of the ovarian tissue about the size of a pea or smaller, and to place this on the medium. At times it is desirable to make cultures from the adhesions on the capsule of the ovary and this can be done in the same way without sterilizing tlie tissue, if the ovary has been handled under aseptic conditions. Generally if an organism can be isolated from the adhesion around an ovary, it can also be isolated from the ovarian tissue itself and it is not necessary to make cultures from both areas except for veri- fication. The oviducts were cultured by sterilizing an area with a heateil spatula and then making an incision into the lumen with a sterile platinum loop. Cultures were made through the fimbriated end of the tube if the latter was not adherent to the ovary. When the genital tracts of smaller animals were cultured, the lumen of the oviduct being too small for cultures, the whole ovary and oviduct on one side were crushed in Rosenow's tissue crusher or ground up with sterile sand in a mortar with a pestle. The apices and body of the uterus were cultured by tearing out a })ieee of the uterine wall, after sterilizing an area from which cultures were to be taken and making an incision through the wall with a sterile knife. If there were fluids in the uterus, they were withdrawn in sterile pipettes and placed on the medium. If the mucosa only was touched with a platinum loop and a bit of the glandular secretion placed on the medium, there was a failure as a rule to get a growth. The organisms, especially the streptococcus, appeared to be living in the depths of the tissue, as the submucosa, and not on the surface of the mucosa. We have demonstrated this, i. e., the streptococcus to be in the submucosa, in several preparations from sections and smears from the uterine wall, especially in chronic conditions. Cultures were taken from the cervical canal bv sterilizing an area on the ilorsal surface of the cer^ix, midway between the external and internal os uteri, with a heated spatula or a gas flame or torch. An incision was made with a sterile knife into the canal and a piece of the mucosa and submucosa was torn out with fine sterile forceps and placed on the medium. The anterior folds of the vagina and external os uteri were cultured in tlie same manner as described above. In calves and fetuses the mucus in the vagina was withdrawn with pipettes and cultured. The vulva and posterior part of the vagina were not cultured in all cases because much work has already been done on these parts and it was an impossibility to care for so many cultures from such a fertile field. Then. too. it was found that the bacterial flora of the posterior part of the vagina and vulva varied in diflFerent herds. AMien pregnant uteri were cultured, the same procedure was carried out with reference to the ovaries and oviducts. The fetal fluids were cultured and the fetal and maternal cotyledons, if these Avere large enough to secure pieces of the tissues. The apices and body of the uterus were cultured at the utero-chorionic space and tissues were also removed from the walls at these points. A piece of the cervical seal was removed, as described above, and cultured. Cultures were made from the anterior folds of the vagina as in the case of tlie non-pregnant uteri. For the most part the fetuses and calves were brouglit or shipped into the laboratory and post mortem examinations and cultures were made there. The alimentary tract was cultured at several different places by means of sterile pipettes, after sterilizing an area with a heated spatula. I'sually the rumen, abomasum, small intestine, caecum and rectum were cultured. The heart's blood, lungs, liver, spleen and genital tract were cultured also. The heart's blood was cultured l)y means of a pipette wliile the cultures from the other organs were made by placing a piece of tissue on the medium. When cultures were to be made from living calves immediately after l)irth, the latter were handled as follows: The cow was placed in a clean disinfected stall just liefore the calf was born. Her posterior parts were washed thor- oughly with a disinfectant and sometimes an entire Ijath was given. The calf was caught on a large piece of canvas whidi had been soaked for a long period in a strong disinfectant. Immediately after expulsion a sterile, soft rubber, horse catheter with a piece of glass tubing in which was a cotton plug, was inserted in the back of the calf's mouth and pushed down the esophagus to the stomach. (It is necessary to have an assistant witii aseptic hands hold open the calf's mouth.) Then the contents of the stomach were sucked up into the tube and tlie contents allowed to escape into a sterile container. The meconium can be collected in a similar manner. The anus of the calf should be disinfected, a sterile, soft rubber, horse catheter inserted into the rectum for a distance of 18 to 20 inches, and sterile water or saline solution from an irrigator run iiito the bowel and the meconium forced out. The meconium, wliicli is usually covered with a tough mucous coat, should be collected in large sterile Petri dishes or other containers and cultured. The 'surface of the meconial mass can be sterilized with a heated platinum spatula and material from the center of the mass placed on the medium. Two or three smears were made upon glass slides from nljarly every tissue from which a culture was made. The smears were stained with methylene blue for various lengths of time, from five minutes to forty-eight hours. Duplicates also were stained with Gram's stain and sometimes carbolfuchsin was used. This was done to check up the cultures in case dead bacteria should be present or living organisms which were not being recovered in culture. Samples of blood were drawn from nearly all animals and the serinu set M-ith an antigen made from Bacterium ahortnw. Each genital tract of the fetuses and calves was carefully described at tlie time when cultures were made. Smillie's (31) method of injecting Guinea pigs and isolating Bacterium ahortum was em])loyed quite generally with the different tissues from which cultures were made. As a rule extracts from ovaries and oviducts were not injected but contents of the uteri, extracts from uterine walls, cervical seals, vaginal secretions and fetal fluids, extracts from fetal membranes, and c% solution of phenol. An incision was made on the median line and the right thoracic and abdominal walls cut away. This allowed the intestinal tract to be removed easily, as shown in Plate II. Then with sterile forceps and a knife, the spleen, liver, and uterus or testes were removed and placed in sterile Petri dishes. Cultures were made from these organs by placing a piece of tissue upon the medium. The cultures were sealed with wax, as Smith suggests, incubated and treated according to the last method described under the different methods of pro- ducing jjartial oxygen tension. A sample of lilood was taken from each pig and set with an antigen made from Bacterium abortuni. When the work was first begim, aerobic and anaerobic cultures were made from the different tissues. Liborius' (.32) method for making the anaerobic cultures was used. Cultures grown under partial oxygen tension were made and altogether four different methods were tested. First. Nowak's (33) method of placing cultures in an atmosphere where B. siibtilis was growing; second, Wright's (34) method with pyrogalic acid and 0.1% solution KOH (one part liquor kali, caust. to ten part H.O). A third method is the following: Culture tubes are placed in large jars with ground glass stoppers. An alcohol lamp is set in the jar and lighted, vaseline is smeared over the ground surface of the cover and the cover placed on the jar. It is necessary to have a hole, 3 to 4 mm. in diameter, bored in the cover. Before placing the latter in position, the hole can be filled with sealing Max. The flame burns only until the oxygen has been consumed and a vacuum has been created. When the cultiires are to be examined, great difficulty will be experienced in removing the cover unless the sealing wax is removed first to allow air from the outside to rush in and replace the vacuum. The fourth method is as follows: The cotton stoppers of the culture tubes may be sealed either with paraffin or sealing wax. In sealing tubes with wax, care should be taken not to push the plug below the mouth of the tube because otherwise it is hard to remove the wax without breaking the tube when the latter is opened for examination. The plan is to form a cap over the cotton plug without allowing any wax whatsoever to drop inside the mouth of the tube. Before sealing the tube, the stopper should be trimmed and flamed. This allows the bacteria which have been placed on the medium, access only to the oxygen in the air sealed up in the tube. The best results have been obtained from sealing the tubes with wax or paraffin. There is much less labor involved when paraffin is used but it means very dirty, disagreeable work when the cultures are examined. Nowak's and Wright's methods, as well as tlie covered jar with the alcohol lamp, are some- what complicated and cumbersome. It was found that they produced a good partial oxygen tension for growing Bacterium abortum but so much condensa- tion water formed in the jars that the growth of streptococci was inhibited to a certain extent. ISIany different media have been used throughout the work. For a long time duplicate cultures Avcre made on various media and grown under diverse methods, until we were certain whicli medium and which method was the best. Cultures were made on ordinary nutrient agar, solidified bovine serum, Loeffler's (3o) blood serum, glucose glycerine agar plus sterile bovine serum. Huntoon's (36) hormone agar, splenic extract bo\iillon, ovarian extract bouillon, and uterine extract bouillon. All these were prepared in the same manner as ordinary peptonized bouillon. Agar was made also, according to Himtoon's method, from the spleen, ovary and litems as well as from genital tracts in early stages of pregnancy, the fetal fluids and membranes bein? ground up with the other tissues. Ordinary nutrient veal agar, or nutrient agar made from peptonized beef bouillon, upon which has been placed either a little sterile serum or a few sterile blood corpuscles collected from a horse, cow or calf, has been employed extensively and with very good results. The Hydrogen-ion concentration of the culture medium seemed to play an import- ant part, especially in the cultivation of the streptococcus. At first a medium was used with Hydrogen-ion concentration of pH. 6.5 but it was found that media at pH. 7 or 7:5 was much more satisfactory. In many instances we did not use the blood corpuscles or serum but. instead, a piece of tissue, from which the culture was made, was placed on the medium. The object is to have some fresh enriching jnaterial to favor the start and gro\vth of the organism transplanted with the tissue. This combi- nation, i. e., nutrient agar (pH. 7-7.5) with some enriching substance such as serum, blood corpiiscles, or a piece of fresh tissue, and cotton stoppers .<;ealed with sealing wax, has given very favorable results and has yielded growths when other media have failed to do so. All cultures were incubated at 37 degrees C. Examination was made 24 to 48 hours after incubation and if no growths were observed, the wax caps were removed and the tissue or other material which had been introduced into the medium was smeared over the surface of the latter and pushed down again into the condensation water. The stoppers were resealed and the tubes placed back in the incubator. If in 48 hours more no growth appeared, the same process was repeated. It is surprising to find how many more growths can be obtained by this procedure. This is especially true in the case of the streptococcus and Bacterium ahortum. If no growth appeared after 10 or 12 days, the cultures were discarded. Bacteriological Findings In order to simplify the work, all the animals whose genital tracts have been cultured have been divided into six groups. Group I consists of genital tracts from pregnant cows. Group II comprises genital tracts from non- pregnant uteri. Group III is virgin heifers. Group IV is made up of calves from 3 to 12 Aveeks of age; Group V consists of calves 1 to 3 weeks old; and Group VI of aborted fetuses or those removed from pregnant uteri. More work has been done on Group II than on the other groups because of the greater ease with which the non-gravid tract is obtained. The majority of these have been cows with abnormal breeding histories. An abundance of material could be had from local slaughter houses and larger abattoirs but one is handicapped witli such material because he knows nothing of the history of the animals. The history has been considered an important factor, especi- ally in connection with the work on the non-pregnant genital tracts. Many tracts in which conception had not occurred have been observed, without apparent lesions, at least nothing that is considered pathological at the pres- ent time could be found. Other factors which might have caused failure to breed, such as a diseased male, had been eliminated. Therefore, in considering a normal genital tract for bacteriological examination, the breeding history seemed very important but we found that it was difficult to obtain such information. The genital tracts of 139 females have been examined and in nearly every case each organ of the tract was cultured. The following divisions were made: Genital tracts from pregnant animals. 11; normal genital tracts from non-pregnant animals, 19; abnormal genital tracts from non-pregnant animals, 50; genital tracts from virgin heifers, 10; calves 3-12 weeks old. 12; calves 1-3 weeks old. 9; aborted female fetuses, 13i: aborted female fetuses whose dams were injected with Bactermm ahortum, 2 : normal female fetuses, 11 ; fermile fetuses removed from cows suffering from dystocia. 2. Twenty-four male fetuses, normal, aborted, and dystocia cases were examined. Besides culturing the genital tracts of the fetuses and calves 1-3 weeks old, a bacteriological examination was made of the tissiies from the rest of the animals. The results of this bacteriological investigation have been extremely inter- esting. The exact locations of organisms isolated from different parts of the genital canal may be seen on the charts. In manv cases all of the cultural .8 characteristics of an organisia have not been worked out farther than identi- fying it according to Migula's classification. It is often impossible to obtain a subculture of an organism from the primary growth. A complete study of the characteristics of certain of these organisms will be carried out in detail and published later. The cultures from the genital tracts of the 11 pregnant animals (Group I — - Chart I) were uniformly negative in five cases. Bacterium abortiitn was isolated from the fetal fluids of one animal while the other cultures from this tract were negative with the exception of the vagina where B. coli was found. Number 6 was negative with the exception of the right uterine apex in which there w^as an unidentified rod, and the vagina in which were B. coli and Sta- pltylococcus albits. Tract 8 gave pure cultures of a streptococcus from nearly every organ, while in Tract 2 growths were obtained only from the uterus and cervix. In the uterus of Tract 3 streptococci mixed with Ps. pijocyaneus were found in the uterus; the external os uteri yielded only a streptococcus. The ovaries and right oviduct of Tract 11 gave cultures of Streptococcus viri- dans in conjunction with staphylococci. From the anterior folds of the vagina of this tract also was obtained a culture «f Staph iilococcus albus. Group II (Charts II, III), in which I have included 69 non-pregnant animals, is of unusual interest. Eighteen are reckoned as normal tracts and fifty-one are either pathological or came from cows with abnormal breeding histories. Of the 18 normal genital tracts, 5 yielded no growths, while 6 gave cultures from the uterus only, the remainder of the tracts being negative. Four tracts showed cultures of a streptococcus from some part of the uterus and also from one of the oviducts. In one case the streptococcus was mixed with a Staphylococms albus. Another tract yielded growths of a strepto- coccus and Staphylococcus albus from the ovaries and oviducts and Ps. pyo- cyaneus from the uterus. Still another tract gave cultures of Stapliylococcus albus from the oviduct and a Gram negative imidentified rod from the cervix. Tract 54 was negative wath the exception of a Staph jjlococcus aureus from the cervix. Under Group II are also included 17 animals slaughtered in one herd. These cows varied greatly in age, 4 being heifers that had never conceived though bred many times. All had been douched regularly and otherwise treated for sterility for many months. Cultures were obtained from some portion of each tract. All of the organisms isolated from these animals fell in the group of streptococci, with the exception of B. coli which was fovmd once in the anterior part of a vagina. The majority were streptococci coming chiefly from the oviducts and ovaries. Occasionally a pure culture of a streptococcus was recovered from the anterior portion of the vagina, the cervix or the uterine apices. In a few cases a staphylococcus was recovered in pure culture from the various organs of the genital canal but usuallv a strepto- coccus was found with it. A saccharomyces was isolated from the uterus of one case. Number 48. The remaining 34 genital tracts from Group II Avere collected from 17 various herds which in most cases Avere long distances apart, 100 to 300 miles or more. With the exception of Tracts 36, 66 and 67, which were obtained from the abattoir and the history of which was not known, and of two cases of pyometra, all of these cows were slaughtered after being condemned for incurable sterilitv. All had received various kinds of treatment for over- coming this condition. For the most part the bacteriological findings were similar to those of the above mentioned 17 cows. The predominating organ- isms were cocci, chief among them being the streptococcus. Staphylococci and occasionally a sarcina were recovered but in nearly every case these were found in coniunction with the streptococcus. Onlv three tracts (8', 9, 61) from this series gave negative results and in only one were growths confined to the uterus alone. In the oviduct of one cow (39) a paracolon organism was found and in a case of hydrosalpinx (2), an organism from the colon- aerogenes group was isolated in pure culture. Bacillus pifogenes and Barillns aerogenes capsulatus were recovered respectively from two cases of pvometra (21 and 24) but in each case a streptococcus was found with the orsranisms named. Bacterium abort um was found in the udder of one heifer (4) that 9 had never conceived. A hemolytic streptoeoceus and Bacterium ahortum were isolated from a tract (30) which was affected with granular venereal disease. Occasionally spore-bearing rods have been recovered from the cervix and several times from other parts of the genital canal. In one or two cases other unidentified rods have been recovered in cultures. A fungus also has been isolated in one or two instances. Groui> III (Chart IV), which is comprised of virgin heifers, showed fewer bacteria than the groups of pregnant or non-pregnant animals. Six of the ten heifers failed to show any growths, while one (7) yielded a spore-bearing rod from the cervix. Number 2 showed a strepto(^occus in both tubes and apices of the uterus, while 8 showed two strains of streptococci. Streptococcus inrdans and Streptococcus hemolyticus (Beta), in the uterus, and a growth of Streptococcus viridans in the external os uteri. Xumber 10 showed kitreptococcus viridans in both ovaries and in the body of the uterus. Group IV (Chart V) consists of 12 calves from 3 to 12 weeks of age. The udders of calves and fetuses were cultured more frequently than were those of adult animals. There was practically no glandular tissue present but, after cutting off the teats, pieces of the fat and connective tissue were removed with sterile forceps and placed on the media. The genital canals of eight of these animals yielded no growths of microorganisms although Bacte- rium ahortum was recovered from the udder of Number 9, which is included in this group. In three cases (3, 4, 10) streptococci were isolated from the ovaries. In two instances (3, 10) they were associated with Staphylococcus aureus. Number 4 gave growths of Staphylococcus aureus, albus and Strepto- coccus viridans from the vagina, while the vagina of number 10 gave a pure culture of B. coli. From the uterus of Number 10 was isolated Bacterium ahortum. The tract of Number 2 was negative with the exception of Strepto- coccus viridans in the vagina. Group V (Chart VI) is made up of genital tracts removed from calves 1 to 3 weeks old dying from various types of calf infections, such as pneu- monia, enteritis, etc. Six of these tracts failed to show any bacteria. Case 6 gave pure cultures of Staphylococcus alhus from the uterus, the rest of the tract being negative. Group VI (Charts VII, VIII, IX, X, XI), in which I have included 62 fetuses ranging in age from 30 days to 9 months, is comprised of 23 fetuses removed from pregnant uteri, 25 aborted fetuses, 5 aborted fetuses whose dams were injected intravenously with Bacterium ahortum, 6 fetuses that were removed from cows suffering from dystocia, and 3 mununified fetuses. The charts upon which the bacteriological data for this group are given show from what tissues, besides the genital tract, microorganisms were isolated. In the case of the 23 fetuses removed from pregnant uteri, the majority appeared normal, although the exact result of the pregnancy, had the fetus remained in utero, cannot be known. Bacterium ahortum was recovered from three of these fetuses. In one of these. Number 26, Streptococcus viridans also was isolated from the meconivim in the rectum, while Bacterium ahortum was not found there. Cultures of streptococci were obtained from 8 fetuses, although in five cases they were found in conjunction with Staphylococcus aureus or alhus. Four fetuses yielded growths of staphylococci, while 8 failed to show growths of any organism. Bacterium ahortum was recovered from 10 of the 25 aborted fetuses (Chart VIII). In 4 cases Staphylococcus alhus or aureus was recovered. Strepto- cocci were isolated from 6 fetuses, 4 cases of these yielding no other organism, while in two cases, 15 and IG, organisms from the colon-aerogenes group v/ere recovered. The stomach contents of Fetus 15 contained a fungus also but this fetus was expelled alive and had swallowed much extraneous material. A Gram positive spore-bearing rod was recovered from the liver of Fetus 2. Staphylococci and organisms from the colon-aerogenes group were recovered from Fetus 4, which was expelled alive. Fetus 33 yielded pure cultures of B. prodigiosus from the heart's blood and small intestine. A hemolytic Staphylococcus albus was isolated in pure culture from Fetus 34. From the 10 stomach contents and intestinal tract of Fetus 54 was recovered a very inter- esting fungus, and Staphylococcus albus was found also. A Gram positive organism similar to B. pyogenes and from which I was unable to get a growth, was observed in smears from the viscera of Fetus 58, which was only IVo months old. The uterine exudate from the dam gave a pure culture of B. pyogenes and the organism in the fetus was apparently the same. Fetus 61 gave a pure culture of a short Gram positive rod, which has not been identified, from the stomach contents. Only two fetuses in this group failed to give growths of any organism. On Chart IX are tabulated the bacteriological findings of 5 fetuses whose dams were injected intravenously with Baoterivm abortiim. This organism was recovered from some part of each fetus but was found in pure culture in only one case. In the other four cases staphylococci also were recovered and in Fetus 32 Streptococcus viridans was found. Two of the six fetuses which were removed from cows suffering from dystocia (Chart X) failed to show any bacteria in cultures. Fetus 5 gave a growth of Streptococcus viridans and a Staphylococcus alhus (hemolytic). From all the tissues of Fetus 31 a fungus was recovered. Fetuses 55 and 56 were twins and from the tissues of both of these an organism that was either B. paratyphoid B or B. enteriditis was recovered. Fetus 31 showed extensive emphysema. The others failed to show any signs of this condition. Chart XI gives the bacteriological data from three mummified fetuses. Fetus 20 gave cultures of Streptococcus viridatis and from the spleen an unidentified Gram negative rod was recovered. An organism from the colon-aerogenes group was recovered from Fetus 49. while Fetus 51 showed the same organ- ism in pure culture. Guinea pigs inoculated with extracts of the tissues from this fetus, however, showed typical lesions of Bacterium abortum and it was iecovered in pure culture from their spleens and livers. The bacteriology of the genital tracts of the fetuses has been of unusual interest. As a rule the distribution of the bacteria throughout the genital canal of the fetus cannot be traced as well as in the adult because of smaller size of the former. The cultures that were isolated directly on the media came for the most part from the uterine cavity, although in some cases Bacterium abortum was not recovered in culture but from guinea pigs that had been injected with extracts made from the genital tract. No cultures were isolated from the vaginae of the fetuses. In no case were bacteria recovered from the male or female genital tracts of fetuses removed from pregnant uteri. The genital organs of 8 female and 7 male aborted fetuses were negative. Bacterium abortmn was recovered from the reproductive organs of 3 females and 2 males, the organism being found in conjunction wnth Staphylococcus aureus in the case of one female. Tlie genitalia of 2 males whose dams were injected with Bacterium abortum were negative, while the genital tract of a third male yielded Bacterium abortum and Streptococcus viridans. From the genital tracts of two females in this group Bacterium abortum was recovered but in the case of one of them, Fetus 39, Streptococcus viridans, Staphylococcus albus and Staphylococcus aureus were also recovered. The results were negative from the genital tracts of one female and two male fetuses that were removed from cows suffering from dystocia. A fungus was recovered from the testes of one male. This fungus was also isolated from the other tissues of the fetus. The genital organs from the pair of twins. Fetuses 55 and 56, a male and female in this group, gave pure cultures of B. paratyphoid. B or B. enteriditis but, as mentioned before, the same organism was also recovered from the other organs of these fetuses. The bacteriology of the genital tracts of the miunmified fetuses could not be worked out satisfactorily. The different microorganisms isolated have in a general way been constant. Tlie majority of the cultures have fallen into the group of cocci. Streptococci have predominated but staphylococci have been quite common. The strepto- cocci most often found associated with the genital organs of cattle and fetuses are those which belong to the rnridans group. The majority of these have been shortchained and composed of rather large, distinctly oval segments. 11 In many eases only pairs were observed hut this was probably due to the medium and to tlie length of time the culture was grown after isolation. Quite a large number of hemolytic streptococci belonging to the Beta type have been recovered, as well as a few strains belonging to the group that Brown ( 37 ) calls " alpha prime." In the latter case immediately surround- ing the colony is a narrow zone of corpuscles that have not become hemolyzed, while surrounding this zone is a broader one in which hemolysis of the cor- puscles has taken place. The various results of the inoculations of these streptococci from the genital canal made upon the sugar media have not yielded anything definite as yet. There seem to be many slight variations in each strain which make anything like classification at present difficult. The staphylococci have been mainly ^staphylococcus alhns and Staphylo- coccus aureus. Some of them have been hemolytic and some non-hemolytic. A larger percentage of the cultures of Staphylococcus aureus has been hemo- lytic than of Staphylococcus albns. Iiu.cteriuni abortuui was recovered from many of the different genital organs. Before definitely designating an organism Bacterium ahortutn, I have injected it into guinea pigs to see if it produced the characteristic lesions, and have made antigens from the cultures and checked them against positive abortion serum. The other biological and staining characteristics have also been carefully worked out. A few Gram positive spore-bearing rods and Gram negative rods which could not be identified were isolated at various times, especially from the cervi.x and anterior part of the vagina, as recorded on the charts. Occasion- ally organisms from the colon-aerogenes group, paracolon types, Ps. pyocya- veus and B. pyogenes liave been recovered but their ciiltural characters are too well known to need description. Experimental In connection with this investigation, experimental work has been carried on with calves of various ages and with a limited number of heifers. The purpose of these experiments has been to find : First, what the effect of some of these organisms would be upon the reproductive organs of young animals if bacteria were injected directly into the uterine cavity ; second, whether the genital canal could free itself of infection when bacteria were injected directly into the uterine cavity, and, if it could do this, how long it would take for the microorganisms to disappear ; third, whether these bacteria had any affinity for, or would localize in, the genital canal, if suspensions of the organisms were injected intravenously. In case of the males the different suspensions of bacteria were injected into the scrotal sac or testicular tissue with a hypodermic syringe. The uteri of the females were exposed through the flank after laparotomy had been per- formed, and the bacterial suspensions injected with a hypodermic syringe directly into the uterine cavity. As a rule the udders of the calves were injected with the same organism which was placed in the uteri. Intrave- nous injections were made in the usual manner. Very heavy bacterial suspensions of Bacterium abortum were used, about twice as cloudy as a bouillon culture of }{. tj/phosus. Four different strains of the Bang organism were used, two from the U. S. Bureau of Animal Industry and two isolated from aborted fetuses in our own laboratory. The cultures were grown on nutrient agar slants, washed off with sterile saline solution, and mixed before injection. The streptococci which were used were isolated from the genital tracts of sterile cows showing extensive lesions, such as adhesions of the different parts. These saline suspensions were not so hea\y as those made from Bacterium abortum. B. proteus vulgaris, which had been isolated from a case of pyometra in a bitch, was injected into the udder and uterine cavity of Experimental Calf 15. After various periods of time, the animals were slaughtered and the genital tracts of the females were removed and ciiltured as described under technic. The testes, epididymes and seminal vesicles of the males were cultured after removal in the following manner. A string was tied tightly around the neck 12 of the scrotum and tlie latter was severed between the string and the abdomi- nal wall before tlie abdominal cavity was ojKjned. The testes and epididymes were lenioved after an incision was made in the abdominal wall on tlie median line and the symphysis pubis severed. Tlie mass of fat at the neck of the blad- der which usually surrounds the seminal vesicle was cut away with sterile for- ceps and knives and the vesicles removed with it. These were placed in sterile towels, taken to the laboratory and cultured in the same manner us similar tissues. Thirty-three animals were used in this exj)crimental work (See Chart X"ll). 12 males and 21 females. They were kept in isolated stalls with tight parti- tions, clean straw being used for bedding. Most of the calves had nothing but whole milk fed to them frcmi individual pails. One or two older animals had some hay and grain. The scrotal sacs of 3 males were injected with 1 c.c. of a living culture of Bacterium uhorluin and two with a live suspension of a Streptwocciifi viri- dans. These were slaughtered in from 17 to 1?> days. A streptococcus was the only organism recovered and this was found only in an atrophied testicle of one of the calves. Six more males were injected intravenously witl: 10 c.e. of the Bacterkitn abortum suspension, many of the animals receiving the injection twelve times, making a total amount of 120 c.c. In none of these cases was Bacterium abortum recovered from the testes, epididymes or seminal vesicles. In one case (23) a 10 c.c. injection of a streptococcus was made following an injection of the Bang bacillus per vein but the cul- tures from this tract were also negative. These six animals were slaughtered in from 3 to 4cS days after the first injection. One female calf received an injection of 1 c.c. of a suspension of Bacteriuvi abortum in her udder. She was slaughtered 51 days after injection but cul- tures from her genital tract and udder were negative with the excejition of one colony of Htaphylococcus albus frcmi one ovary. The uteri and udders of four other females were injected with five c.c. and 3 c.c. respectively of a suspension of Bacterium abortum,. The abortion organism Avas recovered from the uterus and vagina of Calf 7 of this group, after having been inoculated 15 days, and also from the uterus of Calf 13 which was slaughtered after having been inoculated 65 day^-. The organism was not recovered from the other two females although an organism from tlie colon-aerogeues group was recovered from the uterus and udder of Experimental Calf 14 and Ps. pj/o- ci/aneus from her vaginal muciis. The udders of all these females were nega- tive. The uterus of Experimental Calf 8 Avas injected with a culture of i^trcptococeus viridans is(jlated from Fetus 32. Twenty-five days later the organism was not recovered. Experimental Calf 10 received 5 c.c. in the uterus and 3' c.e. in the udder, of a culture of streptococcus isolated from the genital tract of a sterile cow that had endometritis, salpingitis aneen and the corpuscles enlarged. In other cases the spleen was very friable. These conditions are very similar to those observed in the spleens of guinea pigs a short time after they have been injected (10 to 14 days). Apparently this organism has an affinity for the same tissues in the calf as in the guinea pig. Although abscessation of the tissues, such as the liver, epididymes, lungs, etc.. was not ]uodured. it might be done if proportionately the same amount of injected material should be given the calf as the guinea pig. The atrophying of the testicle, as seen in guinea pigs, was not observed in any of the calves injected with Bacterium ahortum. Although in cases where Bacterium ahortnm or the other organism injected M"as not isolated from the genital organs at time of slaughter, staphylococci, streptococci and other miscellaneous organisms were sometimes recovered, Intra-uterine and intravenous injections seemed to have a detrimental effect upon a majority of the calves, especially the youngest animals. In many cases they showed a temporary diarrhea or came down with pneumonia. The grnitnl tracts from those animals which did not thrive during the experi- n\ents were the ones from which bacteria were recovered a< a rule. The serum of all the animals except those that died or were killed a verv short time after injection (23, 24, 30), aaglutinated a Bacterium abortum antigen in dilutions of 1 to 600. This was the highest dilution made. The method of iniection, intravenous, intra-uterine. udder or scrotal sac, seemed to make no difference in the reaction. 14 UlSCUSSIOX AND SUMMAKY To judge from the above work it seems that there is a similarity between tlic bacteriology of the human female genital tract and that of the female of the bovine species. In the human female there is found the gonococcus, while in cattle Bacterium abort mn has a])'parently adapted itself peculiarly Ut the pregnant animal. Aside from these difi'erences the bacterial flora of the reproductive organs of the two species is very much alike. The streptococcus is found predominating in cattle and has been isolated from 174 difl'erent parts of all the genital tracts examined, the staphylococcus 90 times, Bacterium abort urn 17 times, organisms from the colon-aerogenes grouj) 4 times, Bacillus pyogenes capsulatus ;i times. Bacillus pyogenes 3 times, sarcina 3 times, I's. pyocijaneas 3 times, fungi 3 times, B. para- tfjoJioid B twice, paracolon once, and unideiitilied rods eight times. From these data it apj)ears that the genital tracts of cattle should nor- mally be free from bacteria. The results obtained from the younger aninuils seem to support this conclusion although microorganisms are sometimes foiuid in their genital organs. There seems to be a close relationship between Ihe presence of bacteria iii the genital canals of calves and the various symptoms of calf infections observed, especially enteritis and pncinuonia. When a calf has sulTered from such infections, especially from enteritis, and has recoveied, one can, as a rule, isolate, bacteria from the genital canal of thiit calf if it is slaughtered soon after recovery is made. The type of infection may vary and the amount will vary according to the severity of the disease. If the animal is slaughtered even several months after recovery, there is also a greater possibility of recovering microorganisms in culture from the genital canal than from the tract of a calf or heifer that has not suffered from disease. The genital tract of a fetiis or young calf is almost c(mipletely filled v.ith very viscid, tough, faintly cloudy nuicus. The vagina is usually greatly distended with this fluid and remains so for the first four or five weeks after birth. After this time the amount seems to decrease and only the walls of the vagina are covered with it, although after puberty, when the animal comes in estruni, a large amount of this mucus is secreted. Undoubt- edly this has no other than a mechanical action for cleansing the vagina. The nuicus of estnnn differs from the mucus found in the genital canal at birth, the former being very clear and transparent. The latter has been collected with sterile pipettes from the vaginae of calves, placed in vitro, and tested for sterility. Streptococci and other organisms have been placed in the nnu-us and left for 48 hours after which time cultures were again made. 1 have not failed to recover the organism which I had placed in the mucus. FTirther, if the mucus and organisms were incubated for 24 hours, heavy growths of the organisms were found in many cases wiien smears from the mucus were made. The reaction of the mucus in the genital canal of the fetus, when tested wnth litmus paper, is distinctly alkaline or neutral. It cannot have, therefore, a very marked bactericidal action. Observations have been made as regards the matting of the hairs of the vulvar tiifts of these calves, all the animals having been kept imder the same conditions. It has been found that when the hairs are clean and free from fecal matter, pus aTid mucus, cultures from the mucus in the anterior part of the vagina are practically always negative, while cultures made from the vaginae of calves with vulvar hairs soiled with excretions and secretions, practically always yield bacteria. This factor seems to be a safe criterion for differentiating a vagina free from bacteria from one con- taining microorganisms in young females, and no doubt bears some relation to the bacterial content of the reproductive organs of adult animals. In the immature animal it has been found that if the anterior part of the vagina is infected with different microorganisms, the uterus also will con- tain bacteria. The genital tract of an adult cow with a normal breeding history is compar- atively free from bacteria, especially the ovaries and oviducts, cervix and external os. In the case of distinctly diseased genital organs, the majority 15 cf the microorganisms were isolated from the uterine adnexa. Approximately the same number of bacteria were recovered from the diseased uterus as from the uterus of the normal individual. As a rule, the uteri of the diseased tracts had been douchexl with various antiseptic solutions or treated in other ways, and this possibly had an influence upon the bacteria in this organ, keeping the number as low as or even lower than in normal cases (See graphs). Generally only a few colonies, or possibly a meagre growth, have been noted on most of the cultures. This is especially true of the streptococcus which has been recovered so many times, and may be due to the artificial medium upon which the bacteria are gro^Ti. Since the majority ol the cultures from the genital tracts of the pregnant uteri, as well as most of the cultures from the fetuses removed from the latter, were negative, it is difficult to say whether there is a definite relation between the bacterial flora of the uterus and that of the tissues of the fetus. In one case, that of Tract 11, which was distinctly abnormal, the same bacteria were isolated from the fetal fluids as were recovered from the ovaries and oviducts of the dam. In comparing the bacteriology of aborted fetvises with that of fetuses removed from pregnant uteri, there is found a much larger number of bacteria associated with the tissues of the former. It seems strange to find, in checking up thft cultures, that streptococci have not been found in conjunction with Bacterium abortum; Staph}jlococcu^ albu^ and aureus have been associated with the latter many times. Fetus 32 gave pure cultures of a Streptococcus viridams directly from the tissues, but when extracts of these tissues were ground up and injected into guinea pigs, Bacterium abortvm was recovered from the tissues of the latter. The distribution of the bacteria in the fetus is remarkable. In some cases cultures of an organ- ism can be recovered only from the stomach contents, intestinal tracts and possibly the lungs, while in other cases they are recovered only from the heart's blood, spleen, liver, etc. At times bacteria are recovered from all the tissues. It seems that the sources of infection must be different in such cases. Evidently, when the infection is in the stomach contents, intestinal tracts or lungs, it must have entered the mouth of the fetus and have been taken in with the fetal fluids which are being swallowed continually. Where it is found only in the heart's blood, spleen, etc., it must have come directly into tlie blood stream from the cotyledon which may have been infected to such an extent that the epithelium has been damaged and the bacteria carried into the fetal circulation. When the epithelium of the intestine is damaged from toxins or other agents that are capable of destroying the mucous mem- brane, bacteria gain entrance into the circulation, as for example, the Bacillus tifplwsufi in typhoid fever. According to the data that McFadyean and Stockman (38) submit in their work on Epizootic Abortion, they have not found Bacterium abortum in the circulation of the fetus imless it was first present in the intestinal tract, showing that the infection was taken into the circulation from the intestinal tract. In several cases I have recovered bacteria from the fetal circulation and have been unable to get groAvths from the intestinal tract. The original source of the fetal fluids must be the blood stream, but there is apparently some difFerence of opinion as to what tissues excrete or secrete them. They may have two sources or more. The entrance of infection into the fetal fluids also seems to be in doubt. The amniotic fluid which is secreted by the ectoderm of the amnion is the only fluid that the fetus can take into its digestive tract. Therefore, infection must be present at the time of con- ception or within three or four days from that time if it gains access to the amniotic fluid. The only other possible source of infection of the amniotic fluid is the blood supply of the amnion. The kidney of the fetus secretes the allantoic fluid which becomes enormous in amount in the latter period of pregnancy but this does not communicate with the amniotic fluid. Do the bacteria come from the blood through whatever channel the fetal fluids pass, or are they present in the uterine wall or cavity before conception, having been carried there by the blood some time previous? Hagan (39) 16 suggests that the infection comes from the utero-chorionic space and is absorbed or grows into the fetal fluids through the necrotic tip of the chorion which is so common a condition in cattle. When infection is found in the genital tract of the fetris it must have been carried there by the circulatory system. It cannot be stated whether there are certain bacteria which have a sjjecial preference for the genital canal, or whether these bacteria become deposited there accidentally through some special arrangement of the tissues, and find the tract a favorable place in which to remain dormant or to multiply. The source of infection in the genital canal of adult animals presents more difficulties than it does in the fetus or immature animal, where, with perhaps the exception of the posterior part of the vagina, the external source can be eliminated. The two chief reasons for this are the absence of coitus in the yoimg and the mechanical obstruction which the tough mucus of the immature tract must aft'ord to bacteria. Although microorganisms have been isolated from only a few of the genital tracts of fetuses, calves and virgin heifers, a comparatively small number of such animals have been worked upon. It seems evident that a certain percentage carry infection in their genital canals from calfhood to puberty ana that this infection is borne there either by the blood or lymph stream. Probalrly there are certain individuals that are able to eliminate this infection after it is once estab- lished. There is also undoubtedly a group of adults that incur the infection during pregnancy or afterwards, in fact it is not im])ossible for the organism to enter the reproductive organs at any time. Rosenow has shown that certain streptococci, especially the viridwns group isolated from various sources, such as endocarditis, arthritis, duodenal ulcers, and ovaritis, have an affinity for these same tissues when they are injected into experimental animals. Detwiler and Maitland (40) found that these organisms produced the most lesions in the heart and joints regardless of the site of origin of the culture. There is strong evidence to prove that the streptococci which liave been isolated from non-breeders whose genital tracts show lesions, are the cause of these lesions. Rosenow and Davis (41) also have isolated Strentococois viridans from a large number of ovaries of women and have produced ovaritis in experimental animals. They report a case of a yoting girl who had a chronic tubo-ovarian inflammation and also a congenital stenosis of the cervix and uterus. They isolated a Streptococcus viridans from this case. Weiner (42) also reports a case of an 18 year old girl with an ovarian abscess and a comnlete stenosis of either the cervix or vatrina. He cultivated a hemolytic streptococcus from the abscess. In such cases as the last two quoted the source miist be hematogenic since infection by exfension is elim- inated. The case of Experimental Calf 10, which I have mentioned before as receiving an intra-uterine injection of Streptococcus viridans. followed by the characteristic lesions associated with this group of bacteria, supports the pathogenesis of the streptococcus. In a recent paper on Salvivgitis (43), we have shown the relation of the streptococci to the tubes. They were isolated in many cases of hydrosalpinx and other types of salpingitis. In several instances oviducts, apparently normal macroscopically, showed a catarrhal inflammation or a chronic pro- ductive inflammation on section, while streptococci were recovered from the lumen. In the case of several small aborted fetuses (30 to 4.5 days) and in one case of impending abortion (Pregnant Uterus 11), Streptococcus liemolyticus and Streptococcus viridatK'i were recovered. It does not seem possible that these organisms can invade tlip embrvnnic or fetal tissue without cRn«inor «ome damage. It may be that the streptococcus iniures the endometrium to such an extent that the einbryo cannot remain attached to the mucous membrane. If such is the case, and T have recovered streptococci from the uterine wall of manv cases of endometritis where the mucous membrane has become entirely denuded, there is no doubt that many cows which are considered sterile are expelling embryos that are unobserved, because the 17 latter cannot become implanted in the mucosa of the uterus after fertiliza- tion has taken place and they have descended the tube. It seems very prob- able that streptococci which are associated with tlie genital tracts of cows are pathogenic and distinctly so. In the past tliey have been regarded by many as saprophytes, especially the viridans group, but it seems that this predominating group of organisms in the genital canal will have to be considered more seriously if the diseases of the reproductive organs are to be controlled. There appears to be no doubt regarding the pathogenesis of most strains of Bwctcritim abortum. Much work has been done on natural outbreaks of abortion due to this organism, and also experimentally. All of the prema- ture exj^ulsions of fetuses are by no means due to the Bang organism. In the group of aborted fetuses which I have studied, I have found Bacterium abortum in 40 per cent, but if this disease is primarily a disease of the fetal membranes, perhaps a safe percentage basis cannot be established upon the bacteriological findings from the tissues of the fetuses. The placentae have been cultured in many cases and these should be examined in order to eliminate the presence of Bacterium, abortum,. The recovering of Bacterium a^bortiom in the uteri of aborted fetuses and the udders of two veal calves and one sterile four-year old heifer should be noted. The persistence of Bacterium abortum in the uterus of a calf sixty-five days after the injection is also interesting. The length of time that this organism remains in a non- pregnant genital tract has been reported to be comparatively short. Most investigators insist upon working with Bacterium abortum and the prema- ture expulsion of the fetus, but the whole problem of the diseases of the reproductive organs is so serious and so complicated that it cannot be solved by studying one organism and one condition. As the work progresses more scientifically and new factors are found, it is very likely that the percentage of abortion due to Bacterium abortum will become smaller. The pathogenesis of the stai)hylococci and other organisms which have been recovered has not been carefully studied. Their virulence may increase at times or the resistance of the animal become so low that they have an opportunity to produce disease, but they probably have little bearing upon the reproductive organs of a healthy individual. When they do cause disease they have just as important a bearing upon that particular case as would Bacterium abortum. or Streptococcus viridans. A careful search has been made for the spirillum, or vibrio, which Smith recovered from aborted fetuses and described. I found this organism in large numbers associated with an outbreak of abortion in ewes in 1919 (44), but I have not recovered it in connection with my work on cattle. One of the unexpected results of this investigation has been the compara- tive failure to isolate members of the colon group. These organisms are so easy of cultivation that, if they had been present, they would have been recovered. Except for cultures that have been isolated from the intestinal tracts of calves and fetiises that lived for only a short time, I have obtained only five cultures of these organisms and two of these were isolated from vaginae. Judging from the infrequent occurrence of this group of bacteria, it cannot have much weight in the etiology of intra-uterine infections of young calves. In the past much work has been done on the relation of the colon groiip to the so-called " white scours " and to different forms of calf pneu- monia, but I have found this organism in a verv limited number of cases if the calf was killed and cultured before death from the infection had occurred. It would appear that just before death, or at a time when the cells lining the intestines become injured, the large volume of infection normally found in the intestinal tract breaks throusrh into the circulation. In describing this condition, Zinsser (46) savs: "Thus, as Bail has pointed out, a mass of frogs' eggs will remain entirelv uninvaded while alive, though the water surrounding it may swarm with bacteria of many varieties, but when by some accident such a mass of eggs ceases to live, it immediately falls prey to bacterial infection. The same point is illustrated by the rapid- ity with which intestinal bacteria will spread through"but the body after 18 death, when during life, they have remained confined to the lumen of the intestines, or, at most, get into the portal circulation, to be destroyed in the liver. By the living cell, therefore, an opposition is offered to invasion by bacteria, a vital function which Bail has attempted to make clearer by formu- lating it as a law, referring to it as 'Das Gesetz Lebensundurchdringlichkeit.' " I have tried with many of these colon cultures and by many different nietiiods tu produce the same symptoms in calves but have failed in every attempt. .Some hold that this colon group is tlie cause of many of the calf infections because a serum immunized to different members of the colon aerogenes group of bacteria apparently has some beneficial effect upon the course of these maladies. In a discussion of this subject, Professor W. A. Hagan of the New York State Veterinary College at Cornell University sug- gested tliat the beneficial effect of this serum may be due to the foreign protein that is introduced and not to the antibodies formed in this prepara- tion. Because of this, normal serum has been prepared from cows, veal calves, and horses. In some cases whole blood has been used and in other cases, defibrinated blood. The results of this work have proven favorable, that is, in lierds where the normal serum or blood has been checked against the immunized serum, equally as good results have been obtained, and in many cases the calves on normal serum liave recovered more quickly and have been more vigorous than those on immunized serum. Therefore, I fail to see anything specific in the immunized serum that renders it of more vahie in treating these conditions than the normal serum. In three recent outbreaks of these infections in calves, I was unable to isolate the colon organism if the calves were killed and ctiltured a short time before death seemed imminent, or even immediately after death. The contents from the stomachs of the live calves yielded a streptococcus. The meconium and blood cultures and also the placentae from the dams gave tliis same organism in pure culture. In these herds cultures from calves tJiat were expelled dead gave an organism identical with that recovered from the living calves. In many cases I failed entirely to get cultures from the cadaver even though the calf had been dead some time. There is one type of calf infection that is due apparently to unclean food and insanitary surroundings. This is a form of diarrhea and it can be controlled easily by sanitary methods and by disinfecting the navel cord. The colon-aerogenes group may play a part in this type of infection but I do not consider it the primary causative agent. The cause of the intra-uterine diarrhea is apparently the infection that is juesent in the uterus and fetus. It is difficult to find tlie same organisms in a calf that has lived for a time and then died from enteritis or pneu- monia, that have been recovered from its dam. One cannot tell whether the organisms recovered from the dead calf have remained in the tissues since birth or whether they were picked up from some external source. With the exception of the instances mentioned above, I have not, as a rule, recov- ered the same organisms from a calf that has suffered from septicemia, enteritis or pneumonia that I have isolated from the uteri of pregnant ani- mals, though at no time have I been able to secure for bacteriological exam- ination a pregnant animal in a herd that was having heavy losses from these calf infections. There does not seem to lie enough evidence, except clinical evidence, to prov^ that the bacteria found in the pregnant uterus are the etiological factors concerned in the diseases of the young calf after birth. I am greatly indebted in this investigation to Professor W. L. Williams for his valuable suggestions and for the large amount of material obtained from bis department without which much of the work could not have been done. I am iTidebtod to Professor D. H. l^dall of the Department of Medicine and the ambulatory clinic for supplying me with much material for study. I am also indebted to Professor W. A. Hagan of the Department of Bacteriology, to Profess(ir J. IST. Frost of the Department of Surgery, and to Dr. H. L. rJilman of the Department of Obstetrics, for generous assistance. ?0 a) > o • PC ■p o 3 •o > o • o •H > o • ♦ < • ♦J • • • • • >» o > (j, 497. ''^ Walton and Medalia. ,Siirg. Gyn. and Ohs., 1912, 15, 682. Kiister. Kollc und Wassernvann, 1912, VI, 458. Permar. Am. Jour, of Obs., 1917, 75, 652. Rosenow. J.A.M.A., 1915, LXV, 1687. Davis, C. H. Surg., Gyn. and Obs., 1910, 2:;, 5(J0. Miller. Am. Jour, of Obs., 1916, 74, 450. Grad. Am. Jour, of Obs., 1918, LXXVII. urtis, A. X. Surg., Gyn. and Obs.. XX\'l, 1 7S. weedy, E. H. Surg., Gyn. and Obs., XXVll, .503. enzler. Inaugural Dissertation zur Krlangung der Dukterwiirde der liohen Vetcrinarmedizinsclien i"'akultat der Cniversitiit Zurich, 1901. iltncr and Bandcen. J.A.V.:\I.A., 1920, LVIl, 47. on Reuss. Krankliciten der Neugeboroncn, 1914. ^. jL:,.neise. Hegar"s Bcitriige, 1902. 23. Knapp. Monats. f. Geburts. u. Gyniik. 1897, V. 24. Schmidgall, G. Hegar"s Beitrage." 191.3. XiX, 190. 25. Brailowsky-Lounkevitch. Ann. de I'lnstitut Pasteur, 1915, XXIX, 379. 26. Smith, R.M. Med. Record, Sept. 2, 1916. 27. Hymanson and Hertz. Am. Jour, of Obs., 1917. 75, 662. 28. Bang. Jour. Comp. Path, and Therap., 1897, 10, 125. 29. Smith, T. Jour. Exp. Med., 1918, XXVIIl, 701. 30. Rosenow. J.A.M.A., 1914, LXIII, 903. 31. Smillie, Jour. Exp. :\[ed., 1918, XXVIIl. Xo. 5. 32. Liborius. Zeit. f. Hygiene. 1886, I, 115. 33. Nowak. Ann. de 1' Inst. Pasteur, 1908, XXII, 541. Wright, J. Boston Soc. Med. Sci., 1900, V, 114. Loeffler. Mittheilungen aus dem K. Gesundheitsamte, 1894, II. Huntoon, ¥. M. Jour. Inf. Dis., 1918, 23, 169. Brown. Monograph of the Rockefeller Institute for Med. Res., 1919, IX. 38. McEadyean and Stockman. Rep. uf Com. App. by the Board of A"-r. and Fish, to inquire into Ep. Abortion. 1909. 39. Hagan, W. A. Cornell Vet., 1917, 7, 263. 40. Detwiler and Maitland. Jour. Exp. Med., 1918. 27, 37. 41. Rosenow and Davis. J.A.M.A., 1916, LXVI, 1175. 42. Weiner. Surg.. Gyn. and Obs., 1918. 27, 622. Carpenter, Williams and Oilman. J.A.V.M.A.. 1921. 12, 173. Carpenter. Cornell Vet., 1919, IX, 191. Zinsser. Infection and Resistance, 1914, 5. EXPLAXATIOX OF CHARTS C liart I. Pregnant uteri of cows. Chart II. X'ormal non-pregnant uteri of cows. Chart III. Diseased non-pregnant uteri of cows. Chart IV. Uteri from virgin heifers. Chart V. Uteri from calves 3-12 weeks old. Chart VI. Uteri from calves 1-3 weeks old. 20 Chart VII. Fetuses removed from pregnant uteri. Chart VIII. Aborted fetuses. Chart IX. Aborted fetuses whose dams were injected intravounisly witli Bact. abort II in. Chart X. Fetuses removed from uteri of cows sutlering from dystocia. Chart XI. Mummified fetuses. Chart XII. Experimental work. Blank spaces indicate negative results. Spaces witli — — indicate no cultures were made. 21 H w o M < o 3 o o M O < : : 1 : 1 1 1 -3 : 1 1 -a . P 1 1 ^. 3 : 3 : 1 i P ■ O o S g :j^ o . g ; o. i ill 11 « rt rf « ;^ • 1 ■ '* « ( a 5 ^ : 3 o ■g o : 1 o D- : .S : ■ 1 ■ 1 ■ ■ 1 2 '■ 3 ^ * 3 i.i S ; o q 2 5 : S |if? 3 o a "o 11 ■ "^ £: £; Si D. £"3 • • * II m • CG ceC^ ■ ■ 1 CO ■ •! ■ II c : S SiS : ^ i ill -2S 3 o. 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O M £ " Si 51 .MO 3 tlO O . 3 « fl o! - OS 1« a-s 'S6S.5 9"^ c3"H "J t, « m l.^'a 03 * 2-^ "3 *« \ g (3 e J3 03 =3^ ill m ^ 03 g a) g (U <4-l^ O CO *4_, a>t*H oj - C30 ■^■^■^■° O o o o SB S 3 b (-■ O O XiXi (S 03 . » S 3 M 9 6 O 01 > > > _> s-r ID v» ■Ss« 03 c3 03 oi 5? Ml M M c^ 01 41 (U O 03"° n a d e «"J ^ ^ 3 o o o c3 C9 03 03 t4 b kl C"*i -*^ +3 - CD t- § J S 03 03 03 03 .^ +^ .■*^ Ic^ffi •3 '3 '3 '3 01 01 t) O O O O ^_l ^^ ^__, ^ <-i o ID sa 3g a §2 §1 B > 03 3 03 3 03 3 1^ -*^ o "S t> o ■S ° .2 ° 09 6 O "■ a a 3 2^ o g o M O in 'C <» No . S ° • ■^ o o 0) o.S^ o.s-s X! J3 -^ '-' o o 1-t 1-1 rH l-H »-( T-( iJlN ^NCVliN JJiNNiN ^ ^ ^\, ca^^^^"^-- ca^^^^^ 'c3 13 as E"*22 S"*22 a a a>\^ [i,N p^ COCO CO (ihcococo (^ ^ >, >i >. >. >, 03 « 03 S oi TS ■o ■a •B •« '^ •o «> •* 00 O (N U5 N.' P5 s CO CO CO PLATE I A. (Jiiiiu'U |)i,i; rasti'iu'il tn lioard I'v iiicaiis iif slanted nail points wliicli Iticrcc (he Icus. N'isrcra arc ('\|i« ■ ■ -■ C3 ^ c o =1 ^ «i S s a . « ^-, ^ T* ^ •-?^ wr? 7) ^ c '^ Qj ='j 3 I- >i i^' s 0^2^--: o t. o ry, "•3-2 »£ «- «^ -'x-^ . •£ ,^ " 2 ~ «^ = « 5;^ s 3^ S 2 >,~-^ jj •« C3^> J ID £ 03 a^ ■::;.aa ,. "SsStj ? ■5.2 ^.0S |-3 5 ^' S'^j's'o 3'Hi-l a_j- cc ^ M ^ 2 en '* a. M g S C^ ape t : M =' M c • a S^ ?• M' M^ ■ ; -1- W~S. M — 1- MMJ <| I a I -g| I I ■' •*' — I oi "^ o cj - I o: o>- I 00 : PLATE III Testes of tiro guinea pigs injected respectively toith extracts from Fetus 62 and placental extracts. 1 and 2. G.. P. 2i96.— Weijjht 662 gins. 1. Shows tliat testicular tissiie has atropliied wiiih* tlie epididymis is eiihirged and eontains al)S('esses. 2. Right testicle and ei)i(lidyniis are normal. Slanghtered t.") days after injection. Bact. ahortum recovered t'loni epididymis of 1. 3. (_;. P. 234. — Weight (idO gms., testicle normal. Epididymis contains abscesses from which lUict. ahortum was lectjvered. Slaughtered 41 days after injection. PLATE IV Disoari'd iiciiital tract, iiuniln'r (i7. sli(i\\iiig- ovaritis, pavilioiiit is, liydio salf)iiix and perinietriti.s. This trad is typical of those trnin whicii ■;trop1oa\ili(iii adliercnt in mass to left uterine horn. B. Right uterine apex, right oviduct and ovary of Pregnant Uterus 11, pregnant 29 days. Pavilion is ad- lierent to corpus luteuni of pregnancy and other areas on the capsule of the ovaay. The tube is cystic. Ad- hesions have formed since ovulation. A. Right uterine aipex. B. Endometrium (incision has been made in wall of uterine horn). C. Pavilion adherent to corpus luteum of pregnancy. D. Corpus luteum of pregnancy. E. Cystic tube. I'J.ATE \1I i #M r 'af»*i£%f;-. « r s. f r ^^S smSS^^^M A. Genital tract, 8 cm. long, of Fetus 46, showing flic Viiuiii;! greatly distended with nuicus. x 4. A. Right ovarv. B. Body of iitenis. C. ^'a^'ina. B. Smear made from 24 lir. agar culture of a Slrepfococ- <:us viridans recovered from ovaries and adhesions sur- rounding them of diseased genital tract of niuuber 65. ^"•^ ^^^ ■ -^^^ ^^^^-^^ .C'^^^'- -^^ ^"^ ^'p-m^^ ^ v*;^-/?/^'?^-' ^ -n^o^ ^ ^^ *^-«cr-. • ^^^^" ^^ -o.'.* ^^ ^ ,-^'^\'°"'' ^ **\ :>i', o '*'*'"'-'a;^ ^'-^^^ \ ^ -'^ .V °^^ " •- -^..^ .-.^mr. •^^♦^ ■^ -<^/M': & o V * • * '. o .0 ? ^ "^ \r °