DIPHTHEROID ORGANISMS 17 



barred and wedged forms with abundant but small and imperfect granules. On 

 serum it produces a very heavy, confluent, glistening growth with a character- 

 istic salmon-pink color. Ferments dextrose and saccharose, but not maltose. 

 The organism was described by Hoag, but not named by him. The species should 

 be written Corynebacterium hoagi (Morse) comb. nov. 



CORYNEBACTERIUM HODGKINII 



This name is applied to an organism said to be the cause of a glandular 

 disease about which pathologists and bacteriologists are still at odds. In recent 

 years Bunting and Yates, Rosenow, and Billings have been strong adherents to 

 the belief that Hodgkin's disease is caused by a diphtheroid organism which 

 they have cultivated from glandular material obtained from such patients. 

 Organisms similar to those of Bunting and Yates have been isolated from 

 Hodgkin's cases by Rhea and Falconer recently, and according to the earlier 

 work of Fraenkel and Much, and de Negri and Mieremet have been found in 

 similar cases. Fraenkel and Much thought that the organism was related to the 

 tubercle bacillus since it was found by them to be resistant to antiformin. This 

 character has been shown to be insignificant by de Negri and Mieremet who 

 observed the contrary. This test was made on 60 strains of diphtheroids by 

 the writer and in no case was an antiformin-resistant type observed. The 

 first description of this diphtheroid is given by Fraenkel and Much as follows : 

 Granular, antiformin-resistant, gram-positive, nonacid fast. Avirulent for guinea- 

 pigs, de Negri and Mieremet add several cultural characters : Plump short rod, 

 granular, polar staining. Grows best at 32 C. and prefers. aerobic conditions 

 and alkaline reaction of mediums. Abundant growth on Loeffler's serum, with 

 slimy consistency. Bordet medium of blood-glycerin, potato-extract and agar 

 gives abundant growth in 24 hours. According to Bunting and Yates, gelatin 

 is not liquefied and broth is not clouded, but sediment is formed. In this paper 

 it is not proposed to discuss the etiology of Hodgkin's disease, but in review- 

 ing the work of others and from personal studies, it seems that we are not 

 yet ready to ascribe to these diphtheroids the great importance which has been 

 given to them. That organisms similar to these can be isolated from normal 

 individuals as well as from a variety of diseased conditions has been well shown 

 by Bloomfield who made a study of the bacterial flora of lymphatic glands. He 

 found avirulent organisms which were correlated with saprophytes on the body 

 surface in cases of Hodgkin's disease, lymphosarcoma, carcinoma. Another 

 group of organisms seemed to possess a relation to oxygen supply. These 

 were of frequent occurrence. They are short, pleomorphic rods, gram-positive, 

 nonacid fast, no polar bodies and exhibit clubbed forms. Bloomfield found 

 these in cases of lymphosarcoma, arthritis, carcinoma and Hodgkin's disease. 

 Virulence tests on rabbits, guinea-pigs and mice were negative. He concludes 

 that definitely diseased glands yield a greater number of successful cultures than 

 do normal glands. Saprophytic organisms are filtered out by the glands and 

 become a permanent flora of the same. None of the isolated strains appears 

 to be the etiologic factor in specific diseases. Another study by Fox has thrown 

 further light on the question of secondary invasion. Fox found that no one 

 bacterial variety with definite morphologic and cultural characters has been 

 isolated from cases of Hodgkin's disease. That these diphtheroids may be found 

 in enlarged glands in other conditions is mentioned by Fox and has been 

 observed by the writer who has isolated organisms morphologically and cul- 

 turally identical with the so-called C. Hodgkinii, from an hypertrophied tonsil 

 and from lymph nodes and other sources. For the sake of comparison the fol- 



