ON THE ANTITOXINS OF DIPHTHERIA. 195 



outstripped that of any other bacteria originally associated 

 with it. Practically this is by no means always the case, 

 since a large percentage of cultures at the end of twenty- 

 four hours show vigorous growths of streptococci and allied 

 pyogenic cocci. Deycke (7) has given the following 

 formula for a culture medium which is claimed to be even 

 more sensitive than that of Loftier. 1 per cent, solid alkali- 

 albumin prepared by Merck of Darmstadt, '5 per cent, 

 sodium chloride, 2 per cent, agar, and 5 per cent, glycerine. 

 This is neutralised and then made alkaline by the addition 

 of 1 per cent, soda solution containing 1 part of soda to 2 

 of water. With this medium Wolff (8) has isolated diph- 

 theria bacilli from the cavities of the tympanum, frontal 

 sinuses and antrum of upper jaw. When inoculated into 

 guinea pigs the bacillus gives rise to a diphtheritic process 

 which may be followed by temporary paralytic symptoms 

 similar to those pathognomonic of human diphtheria. This 

 micro-organism can therefore be experimentally transferred 

 from man to animals, but there is no evidence sufficient to 

 prove that the converse can take place, for the diphtheria 

 which affects calves and pigeons apparently is not com- 

 municable to man. Oertel, whose work marks an epoch 

 in the diphtheria question, has objected that the experi- 

 mental disease is not identical with that observed in man, 

 but this view can hardly be sustained since, as Babes and 

 others have shown, the histological changes in cases of 

 spontaneous and experimental infection are identical (2,8). 

 Loffler's discovery, at first" received with some hostility, 

 has been abundantly confirmed, and among the countless 

 microbes of the mouth, nose and pharynx, some of which 

 are pathogenic and some harmless, the Klebs-Loffler 

 bacillus alone is capable, when present, of thriving on the 

 mucous membrane and causing diphtheria. For other in- 

 flammations of the throat this term should be discarded, 

 since if clinically there is a difficulty of diagnosis, a bacterio- 

 logical examination may be relied upon to afford a convincing 

 distinction between true and pseudo-diphtheria, though it 

 may be mentioned that Bacillus diphtherias may exist in the 

 mouth without giving rise to any symptoms of disease. 



