26 DAVID J. DAVIS 



in number. Streptococci and pneumococci were found in every 

 plate, the latter always predominating. The M. catarrhalis was 

 found in 10 of the cases, being extremely abundant in two. Diph- 

 theria bacilli were obtained from the throats in two cases. They 

 were large curved bacilli containing large granules, and the col- 

 onies showed a distinct, clear zone of hemolysis. One of the 

 cases had a profuse nasal discharge during convalescence. In this 

 material were found by culture pneumococci, streptococci, a few 

 diphtheria bacilli and a considerable number of influenza-like bacilli. 

 Four of the cases were complicated with otitis media, and the pus 

 was examined in each case. In one case the influenza-like bacilli 

 were obtained nearly pure, there being present also a few strepto- 

 cocci. In this case the bacilli had been obtained from the throat 

 about a week previously; n days later the pus was again examined, 

 and showed no influenza bacilli, but nearly a pure culture of a bacillus 

 of the diphtheria group. From the other three cases streptococci 

 were obtained, pure in one of them, and streptococci and diphtheria 

 bacilli, mixed, in the remaining two. 



Clinical influenza or grippe. The sputum was examined from 

 17 cases that were diagnosed clinically as acute influenza. They 

 occurred at a time when there was reported to be an epidemic of 

 grippe in the city.. In only three cases were the influenza bacilli 

 found, and in only one of these were they very numerous. Strepto- 

 cocci were very conspicuous in these cases, and while not so numerous 

 as pneumococci, they were more abundant than in the other groups 

 examined. 



Epidemic cerebrospinal meningitis. In five cases of typical 

 cerebrospinal meningitis the influenza-like bacilli were found either 

 in the nose or throat of four. The case in which it was not found 

 had been sick for three weeks when examined, and at that time 

 showed no nasal or throat symptoms. The other four cases were 

 examined early in the disease, and showed some nasal and throat 

 symptoms. In one of these the meningococcus was isolated from 

 the nasal cavity and also the sputum, and in this same case the 

 influenza-like bacilli were also present in large numbers, being by 

 far the predominating organism. The meningococcus was culti- 

 vated from the cerebrospinal fluid in each of the five cases. 



