518 J. H. RICHARDS 



The feces of all cases was examined by Gram stain, and those 

 that showed streptococci on the slide were cultured. Strepto- 

 cocci were found by the Gram stain in 42 cases, and were isolated 

 and identified as Streptococcus viridans in 5 cases. This is an 

 interesting phase of the work and we are continuing work along 

 this line. The technique of making these cultures was as follows : 

 Select a loopful of clear mucus, wash thoroughly in saline, and 

 plant several plates very thinly. Even by this method we had 

 great difficulty in obtaining the five positive cultures on account 

 of the rapid overgrowth of other bacteria found in the stool. 



The technique of culture of the various foci is as follows : 



Teeth. When a sinus or pyorrhoea was present a culture was 

 taken directly from the pus. This pus was usually found to con- 

 tain two or more types of bacteria. When a tooth was withdrawn 

 a culture was taken from the root and the socket, and frequently 

 Streptococcus viridans was found in pure culture. 



Tonsil. After gargling with sterile saline a loop was inserted 

 as deeply as possible into a crypt of the tonsil using a pillar re- 

 tractor when necessary for a clear view. If the tonsils were 

 removed a culture was made from the deeper portions through 

 an incision of the tonsillar capsule. 



Ethmoid and sphenoid cultures were taken from the discharges 

 from these sinuses after cleansing the nasal cavity with sterile 

 salt solution. The material to be planted was taken as nearly 

 as possible from the opening of these sinuses. In cases 3 and 7 

 the cultures were taken directly from the sinuses during an opera- 

 tion by E. Ross Faulkner. The other nasal sinuses were cultured 

 in a similar manner. 



Prostate. After urinating, the prostate was massaged and the 

 culture made directly from the discharge. 



Pyelitis. The sediment from a freshly catheterized urine was 

 immediately planted on North's medium. 



Salpingitis. The one case was cultured at the time of operation. 



From a study of the table herein appended giving a summary 

 of the 104 cases it is found that 



1. In blood cultures Streptococcus viridans was found in 14 

 cases out of 104 cases. 



