BACTERIOLOGY OF WHOOPING-COUGH 25 



on the first day of symptoms revealed almost a pure culture of the 

 influenza-like bacilli. They were present both in the throat and on 

 the nasal mucosa, in enormous numbers. Direct smears of the 

 expectorated mucus showed practically no other organism. They 

 were identical in every detail with the organisms inoculated. Exami- 

 nations of the throat were made every few days for four weeks, after 

 which time the patient was not accessible. The number of organisms 

 present became gradually less, but at the end of that time they were 

 still present in considerable numbers. 



From this experiment we must conclude that this organism 

 develops in the human throat when implanted there, and is capable 

 of causing a distinct reaction. The fact that pertussis was not pro- 

 duced by this one inoculation by no means excludes this organism 

 as an etiologic factor in the disease. For, in a case of this kind, it is 

 impossible to be absolutely sure that the individual has never had 

 the disease, and adults at this age may be immune. The result does 

 indicate surely that this organism, present almost constantly as it is 

 in pertussis, and capable of producing such reaction in an adult, 

 must be of some significance in the disease, and is at least not always 

 a harmless saprophyte. 



V. INFLUENZA- LIKE ORGANISMS IN OTHER DISEASES AND IN NORMAL 



THROATS. 



The occurrence in other diseases of what appears to be the same 

 organism, morphologically and culturally, is of interest. A number 

 of examinations were made of sputum and throat swab by the same 

 method as that used in whooping-cough, from cases of measles, acute 

 influenza, epidemic cerebrospinal meningitis, bronchitis, varicella, 

 and from normal throats. 



Measles. Twenty-two cases of uncomplicated measles were 

 examined. The sputum was obtained in most of the cases, but in a 

 few this was impossible, and throat swabs were used. All were 

 examined during the stage of eruption, and most of them had at the 

 time the usual cough present early in the disease. Only one exami- 

 nation was made in each case. The influenza-like bacilli were iso- 

 lated in pure culture in 13 of the 22 cases. In four of the cases they 

 were the predominating organism ; in some cases they were very few 



