304 Pneumonia 



throat in diphtheria. In pure culture it was obtained from 

 vegetations upon the valves of the heart in a case of 

 acute endocarditis with gangrene of the lung; from the 

 middle ear, in a case of fracture of the skull with otitis 

 media ; and from the throat in a case of tonsillitis. 



Occasionally Friedlander's bacillus bears an important 

 relationship to lobular or catarrhal pneumonia, an interesting 

 case having been studied by Smith.* The histologic changes 

 in the lung were remarkable in that the " alveolar spaces 

 of the consolidated areas were dilated and for the most 

 part filled with the capsule bacilli." In some alveoli there 

 seemed to be pure cultures of the bacilli; others contained 

 red and white blood-corpuscles; in some there was a little 

 fibrin. The bacillus obtained from this case, when injected 

 into the peritoneal cavity of guinea-pigs, produced death 

 in eleven hours. The peritoneal cavity after death con- 

 tained a large amount of thick, slimy fluid; the intestines 

 were injected and showed a thin fibrinous exudate upon the 

 surface; the spleen was enlarged and softened, and the 

 adrenals much reddened. Cover-glass preparations from 

 the heart, blood, spleen, and peritoneal cavity showed large 

 numbers of the capsule bacilli. 



Howard f has also called attention to the importance of 

 this bacillus in connection with numerous acute and chronic 

 infectious processes, among which may be mentioned 

 croupous pneumonia, suppuration of the antrum of High- 

 more and frontal sinuses, endometritis, perirenal abscesses, 

 and peritonitis. 



Virulence. The virulence of the organism seems to vary 

 under different conditions. It is sometimes perhaps 

 usually harmless for the experiment animals, sometimes 

 produces local inflammatory lesions, sometimes invasion of 

 the circulation and death from sepsis. 



CATARRHAL OR BRONCHO-PNEUMONIA. 



This form of pulmonary inflammation occurs in local 

 areas, commonly situated about the distribution of a bron- 

 chiole. It cannot be said to have a specific micro-organism, 

 as almost any irritating foreign matter accidentally inhaled 

 may cause it. The majority of the cases, however, are 



* "Jour. Boston Soc. of Med. Sci.," May, 1898, vol. n, No. 10, p. 174. 

 f "Phila. Med. Jour.," Feb. 19, 1898, vol. i, No. 8, p. 336. 



