80 



As genera] procedure I have not washed the particle of spiv 

 turn used for cultivation although several authors (Jochmann (I), 

 Levinthal (1,2)) have laid great stress on washing; others however 

 (Rosenow) have not considered it necessary. It is clear that if 

 one wants especially to investigate the bacterial flora of the bron- 

 chial secretion one ought to remove the outer layer of the sputum 

 as far as possible by suitable washing. But the object here was 

 only to investigate whether Pfeiffer's bacillus was present at all 

 in the patient, and it would rather be an advantage to oblain a 

 mixed sample containing materiaJ from the bronchial tubes, the 

 throat, and the mouth, with the proviso however that the olher 

 bacteria present in the last-named places, were not capable of over- 

 growing Pfeiffer's bacillus to any considerable extent. 



In cultivations from 6 samples of sputum with and without 

 washing I have been unable to discover any sign whatever that the 

 cleansing gave a better chance of demonstrating Pfeiffer's bacillus. 



In order to estimate the importance of rapid examination cul- 

 tures were made in some cases from the sputum immediately after 

 they were received as well as on the following day after being 

 kept in Petri plates at room temperature in the meanwhile. It was 

 found with great regularity that in the course of a single day 

 Pfeiffer's bacillus decreased considerably in numbers or even dis- 

 appeared entirely. 



We must therefore reckon with the fact that in looking for 

 this microbe in sputum etc. a day's delay before cultivating will 

 diminish the number of positive findings to a marked degree, so 

 that the greatest possible expedition in the examination is important. 



As regards the investigations reported here it cannot be said 

 that this desideratum is so well fulfilled as could be wished, but 

 better in the investigations of 1922 than in the earlier ones, and 

 perhaps this fact, — in conjunction with the investigations earlier 

 in the disease, — is sufficient to explain the higher percentage 

 in the last case. 



The results of the examinations for Pfeiffer's bacillus in 

 influenza can shortly be summed up thus: the bacillus was 

 found in all 4 epidemics and widely distributed in the last 3, 

 but it was probably considerably more restricted in the first. 

 It cannot be decided whether any change in its distribution has 

 taken place during the last 3 epidemics. It was found most 

 constantly in the beginning of the disease but as a rule it did 

 not disappear as quickly as indicated in the investigations of 

 Wassermann, Piras, and Gosio. It was found nearly as often 

 in pneumonia as in uncomplicated influenza. 



