SHERWOOD: PLEOMORPHIC STREPTOCOCCI. 255 



SUMMARY AND CONCLUSIONS. 



1. That a pleomorphic organism quite similar to if not identical 

 with Streptococcus scarlatina of Gordon and Streptococcus conglom- 

 eratus of Kurth was isolated by me from chronically enlarged 

 cervical lymph glands of an individual having no history of scarlet 

 fever. This organism showed all transitions between bacillary 

 form and chains of diplococci. 



2. That a vaccine was apparently beneficial, and that since 

 tonsillectomy no recurrence has taken place. The tendency for 

 recurrence after three months is another example of the transient 

 immunity resulting from streptococcus vaccination. It is a well- 

 known fact that streptococcus infections do not confer a lasting 

 immunity. This is one thing that should give us pause in ascribing 

 to streptococci the primary cause of such diseases as scarlet fever 

 and measles where a comparatively lasting immunity results. 



3. That a simila,r organism was isolated from a hand infection, 

 from two cases of bronchitis, and from five out of 365 cases of 

 tonsillitis. Frequently pleomorphic streptococci showing other 

 colony types on agar and Loeffler 's blood serum were also observed 

 in tonsillitis cases. 



4. That some of the involution forms of this streptococcus 

 might be mistaken for B. diphtheria by other than a well-trained 

 observer. This is of importance in view of the many relatively 

 inexperienced individuals doing laboratory work either for them- 

 selves or as a commercial proposition. It is of added interest in 

 view of the observations of Gordon and Newman, suggesting a 

 relationship between the streptococcus group and the diphtheria 

 group. This has more recently been emphasized by Mellon, 



5. That during the diphtheria epidemic in Kansas City in 1914 

 a number of patients showing only pleomorphic streptococci in 

 nose and throat smears and cultures, nevertheless recovered rap- 

 idly following administration of 10,000 units of antitoxin. Similar 

 results were obtained in a small series of cases in Lawrence. This 

 may or may not mean anything. If the apparent beneficial re- 

 sults were real and not a coincidence, and if no unfound foci of 

 diphtheria existed, it might not indicate a relationship between 

 these organisms and B. diphtheria, but could be another example 

 of nonspecific protein therapy as reported by Muller, Miller, 

 Weichardt and others. 



6. That according to Andrew and Horder's classification the 

 pleomorphic organism I am reporting upon appeared to be the 

 same as Streptococcus anginosus. 



