1919] on A Filter-passing Virus in Certain Diseases 559 



to recover it during afebrile stages, and this is especially true of 

 trench fever and of nephritis. The percentage of successful recoveries 

 is, of course, much less than during the febrile period. In trench 

 fever the virus can be recovered by culture in about 30 per cent of 

 cases during the afebrile periods between the separate relapses. The 

 blood, however, is not the only fluid from wliich these organisms 

 can be recovered by culture. In influenza, for instance, it can be 

 readily obtained from the sputum during the early stages of the 

 disease, as it is then present in enormous numbers. In nephritis it 

 can similarly be recovered fi'om the urine, and in encephalitis from 

 the cerebro-spinal fluid, but not in all cases. Up to the present time 

 it has not been recovered from the cerebro-spinal fluid in cases of 

 polyneuritis, but the number of cases investigated with this point in 

 view has not been large. In influenza complicated with pleurisy or 

 meningitis it can be obtained from the pleural or cerebro-spinal fluid, 

 as the case may be. 



These organisms can, however, not only be recovered by culture 

 from the blood, secretions, or exudations of the body, but they can 

 be actually seen in certain fluids and cells of the body. Thus, in 

 influenza it can be seen, with suitable methods of staining, in the 

 sputum during the early stages of the disease, and it is then present 

 in large numbers ; further, it can be seen in the free state in the 

 pleural fluid of influenzal pleurisy, and also in the mononuclear 

 leucocytes present in the pleural effusion. In nephritis the specific 

 organism may be seen in considerable numbers in the centrifugal ised 

 deposit obtained from the urine. In trench fever the organism has 

 been seen in stained films of the blood, in the plasma, in the red 

 corpuscles, and in the mononuclear leucocytes. In encephalitis it has 

 been seen in some cases in the cerebro-spinal fluid. These observa- 

 tions have some practical importance, inasmuch as they may assist in 

 the diagnosis of some of the more obscure and diflicult diseases, e.g. 

 lethargic encephalitis. 



Certain facts of interest are observed in regard to the distribution 

 of these organisms in the tissues of fatal human cases. The globoid 

 bodies have a wide distribution in the nervous system, inasmuch as 

 they can be recovered from the brain, spinal cord, and such nerves 

 as the sciatic. They are also found in the lymphatic glands, but not 

 in the liver or spleen. In fatal cases of influenza the causative 

 organism is very widely distributed in the lungs, heart, liver, spleen, 

 kidney, brain and lymphatic glands. In rabies it is found in the 

 nervous tissues, and also in the salivary and lymphatic glands. It 

 would seem as if the lymphatic glands were a favourite site for these 

 filter-passing organisms. 



These organisms are difficult to stain satisfactorily, and the best 

 results hitherto have been obtained by staining with 1 per cent 

 methylene -blue, after washing the film with ether. It is also 

 difficult to keep well-stained specimens for any length of time, 



