14 DAVID J. DAVIS 



Organisms corresponding to M. catarrhalis, as described by Pfeif- 

 fer, occurred in large numbers in a few cases. They occur in pairs, 

 being indistinguishable in smear from the meningococcus. Usually, 

 when present, they are seen in large numbers inside the leucocytes 

 in the sputum. 



Influenza-like organisms. In these cases attention was particularly 

 directed to the occurrence of the influenza-like bacilli. Usually they 

 were found in the first examination. In this series 44 of the 61 cases 

 required but one examination 'to find such bacilli. In 12 of the 56 

 cases in which they were found, two or more examinations were 

 necessary to find them. In five of the 61 cases they were not found, 

 but in three of these only one examination was possible; in the 

 remaining two, two examinations were made in one, and four in 

 the other, with negative results. In two cases the organisms were 

 found several days before the patients had been heard to whoop, 

 but they had at this time a severe cough and expectorated considerable 

 mucus. In six cases where the children were known to have been 

 exposed to the disease, and were showing some symptoms of a dry 

 cough, swabs of the throat were examined for these bacilli, but in 

 none were they found. They all developed typical whooping-cough 

 in from one to two weeks later. As to the length of time these organ- 

 isms persist in the throat, present data will not suffice. One case 

 that had developed pertussis in the spring and had ceased coughing 

 during the summer, began to whoop again in the fall, i. e., about six 

 months from the first attack. The sputum at this time contained 

 an abundance of the bacilli. A brother of this child, who also had 

 pertussis in the spring and recovered during the summer, but who 

 did not cough in the fall, also showed large numbers of the same 

 bacilli in his throat at this time. The organisms were as abundant 

 in the adults as in the young children. It may therefore be said that 

 these bacilli occur practically constantly in the throats during the 

 spasmodic period, and even slightly before this, but probably not 

 during the initial stage of the disease. 



The bacilli were often extremely numerous, in a few cases being 

 nearly in pure culture; this, however, depends largely on how 



whooping-cough, but of the diseases given in Table 2, as well as in the 20 normal throats examined, 

 they should be considered the normal inhabitants of the throat. It is of interest that organisms of this 

 type are practically absent on the normal nasal mucosa as shown by the examination of the same 20 

 normal cases that yielded them in abundance from the pharyngeal mucosa. 



