244 DII-MTHKIIIA IN THF, TKOIMI'S 



December 1(3, 15)09. St-ruiii riiluiios from swab. I'uru yiowtli of Ciiiiiii-iiet'ative cocci 

 foriniii^ siimll, Hat, iliserete colonies very like those of B. diphtlu-riii'. Neisser + but 

 faint. (Iniiii both -f 'I'ni so fill" as granules were concerned. 



December 17, 1909. Agar culture from serum. Witliin 2i hours Gram -)- clubbed and 

 beaded rods had appeared, and were found along with the Gram ■ coccus. Both 

 forms were lui.xed in masses. .Many of the rods resembled typieal II. iliphtheriae, a 

 considerable number being of the diplo-bacillary type, to the illustration of which, 

 iu Nuttall's and Graham-Smith's text-ijook, reference has already been made. 

 Some of the rods were nearly or completely Gram — but the majority retained 

 the stain. 



A confirmatory serum subculture, made at the same time, showed only cocci. 

 Some curious swollen-looking forms were present. 



December 18, 1909. 48-hours' agar culture. Same rod forms seen. No cocci. A certain 

 number of the bacilli presented a well-marked beaded appearance. At this stage some 

 rather suggested Hofmann's H. pscndo-iUphtheriie, possibly owing to the progressive 

 change in morphology they were undergoing. No true metachromatic granules were 

 obtained on staining with Neisser. 



December 19, 1909. 72-hours' agar culture. First appearance of barred and of involution 

 Gram + forms. Three distinct tj'pes present. Stout Gram -)- rods and Gram — ■ rods 

 and Gram —cocci some of which, however, showed distinct dark granules. A 72-hours' 

 broth culture exhibited nuicli the same appearance, but most of the rods were Gram — . 

 Beaded rods were marked (Plate XIV., lig. 2). 



December W, 1909. 96-hours' agar culture. Further increase of bacillary forms. Involution 

 forms more marked. Nearly all the rods Gram -f • Beaded and barred forms much 

 in evidence. On staining with Neisser no definite iiietaclu-omatic granules obtained, 

 but it was found that transference to serum plates resulted in the appearance of 

 Neisser's dots which in the majority of the rods were bipolar. 



December 22, 1909. The observations were made every day, but one may pass to the 

 144-hours' agar culture. It proved practically w-holly bacillary, the great majority 

 of the rods being also Gram +. Involution forms of the clubbed type assumed by 

 li. diphtheriie appeared after 248-hours' growth on agar, and were marked in a 

 288-hours' culture, which showed various swollen and irregular forms as well. Typical 

 barred and beaded forms still persisted as did coccal forms, and it was a point of 

 interest that some of the Gram-negative rods looked as if they were reverting to the 

 diplococcal form. A serum tube culture of the same age presented a very similar 

 appearance. 



From this date onwards, involution proceeded apace. Amorphous masses were 

 found in films stained by Gram and prepared from a 432-hours' old agar culture. The 

 changes were like those seen in li. iliplithoriie undergoing involution and degeneration, 

 and the last cultiu'e examined in this series was a 672-hours' old agar growth of 

 January 13, 1910, which showed, when stained by Gram, extreme degeneration of 

 the bacilli, scarcelj' any recognisable bacilli being left, but the dark stained polar 

 bodies still showed up well. The few coccal forms remaining were much swollen. 

 At a later period, time permitting, a few further observations were made. 



March 1, 1910. An old agar culture made on February 5, 1910, was found still to be 

 alive. It showed Gram -f involution forms, many clubbed forms, and a few Gram — 

 rods. No cocci were found. A subculture was made on agar, and, after 48 hours, one 

 was astonished to find an almost pure coccal growth, the organism being for the most 



