ABSTRACTS 383 



solid forms in about 42 per cent of cultures, while short solid types were 

 uniformly found to possess no virulence. The authors, especially 

 emphasize the importance of tests for virulence in recovery cases be- 

 fore dismissal and in suspected carrier cases. — R. M. T. 



A Preliminary Report on Pneumonia in Children, with Special Reference 

 to its Epidemiology. Godfrey R. Pisek and Marshall C. Pease. 

 Am. Jour. Med. Sc, 1916, 151, 14. 



In an analysis of 1000 cases of pneumonia, not including those cases 

 secondary to other infectious diseases, the authors found a mortality 

 of 34.5 per cent in children under six years of age in the Babies' Wards 

 of the New York Post-Graduate Hospital. The series contained 445 

 cases classed as bronchopneumonia which occurred chiefly during the 

 first two years of life, and were relatively uncommon after the third 

 year. The lobar form also occurred more frequently during the first 

 two years, and was the type usually found after the third year if the 

 terminal and secondary infections following other diseases are ex- 

 cluded. The highest mortality was found in the first year of life with 

 both forms, but relatively less frequently with the lobar. No evidence 

 was found of either epidemic or house infection in studying the cases. 

 The authors felt that the broncho- and lobar types formed rather dis- 

 tinctive groups clinically, their conclusions being based upon both 

 pathological and bacteriological differences. For bacteriological study 

 the materials were taken from the upper part of the larynx by means 

 of a bent applicator. In 23 cases of lobar pneumonia, with sputum 

 virulent for mice, all showed Gram-positive diplococci predominating 

 in nearly every case with a few streptococci and staphylococci. In 



10 cases of mild bronchopneumonia with sputum which seemed virulent 

 to mice, the predominating organism in 5 cases was the streptococcus. 

 2 cases each showed staphylococci and the influenza bacillus, and 

 in 1 case, tubercle bacilli with other organisms. In 4 cases a few 

 pneumococci were present. In 8 cases of bronchopneumonia with 

 sputum virulent to mice, smears showed large numbers of pneumococci, 

 in addition to large numbers of other organisms, chiefly streptococci 

 and staphylococci. Bacteriologically, the authors consider broncho- 

 pneumonia as being a mixed infection, or an infection chiefly with one 

 type of organism other than the pneumococcus. This differentiates 

 this form from the lobar type, which is due chiefly or entirely to the 

 pneumococcus. A study was made of the types of pneumococci 

 occurring in a group of 48 clinical cases of pneumonia, which gave 

 conclusive results. Of these, 28 cases were classified as lobar and 20 

 cases as bronchopneumonia. For this purpose the Dochez-Gillespie 

 grouping of pneumococci was followed, using specific sera for Groups 

 I and II prepared by the Rockefeller Institute, and the methods recom- 

 mended by them. The series gave the following results: Group I, 



11 cases; Group II, 14 cases; Group III, 4 cases; and Group IV, 19 

 cases. Cases clinically classed as lobar pheumonia showed pneumo- 

 cocci Groups I and II, decidedly predominating, while more than 



