220 BIOLOGY OF PNEUMOCOCCUS 



elapsed since the serological classification of pneumococci has been 

 enlarged to comprise thirty-two types that the few type analyses 

 in bronchopneumonia can only be looked upon as suggestive. In one 

 of Heffron's tables listing the types of organisms found in this dis- 

 ease in East Africa, Germany, Great Britain, India, and the 

 United States, totalling three hundred cases, it is seen that Type I 

 pneumococci were found in 6.3 per cent, Type II in 4.3 per cent, 

 Type III in 14 per cent, and organisms of the fourth group (type 

 not specified) in 75.3 per cent of all cases reported. There is a 

 marked difference in the reported figures between the incidence of 

 Types I and II combined (10.6 per cent) in bronchopneumonia 

 and their incidence in lobar pneumonia (over 50 per cent). 



In observations on the presence of the various pneumococcal 

 types in bronchopneumonia, Sutliff and Finland found that the 

 ten types occurring in a series of 174* cases were, in order of fre- 

 quency, Types III, VIII, XVIII, X, V, VII, XX, II, XI, and 

 XIV. Additional data are given in the communication of Trask, 

 O'Donovan, Moore, and Beebe. 1417 Studying the relation of pneu- 

 mococci of the first three types to pneumonia, the latter authors 

 noted that, in patients suffering from Type I or II infections, 

 bronchopneumonia was rare, but with Type III this form of the 

 disease constituted one-third of the affections. Sutliff and Finland 

 reported that 21 per cent of the Type III and 30 per cent of the 

 Type VIII infections studied were cases of bronchopneumonia, 

 whereas only 3 per cent of the Type I and 5 per cent of Type II 

 affections were diagnosed as bronchopneumonia. The early studies 

 at the Hospital of the Rockefeller Institute pointed to extrinsic 

 infection as the cause of lobar pneumonia, whereas the few data 

 available seem to indicate that bronchopneumonia arises more 

 commonly from intrinsic infection or auto-inoculation. 



In the case of bronchopneumonia following other affections of 

 the respiratory tract, the infection is largely due to the bacterial 

 species more commonly present in the air passages, among which 

 the streptococci predominate. Pneumococci of the fourth, hetero- 



