MICROCOCCUS INTRACELLULARIS 359 



by the self-digestion (autolysis) that this organism is known 

 to experience under conditions of artificial cultivation. 



As seen in cultures, it is commonly arranged in pairs with 

 the individuals flattened at the surfaces of juxtaposition. 

 Sometimes it is seen grouped as four and occasionally as 

 short chains of three or four cells, but never as long chains. 

 Its size is that of the common pyogenic micrococci, and its 

 outline and arrangement in the pus-cells are so like those of 

 the gonococcus that the figure depicting gonorrheal pus 

 answers equally well to illustrate the appearance of the 

 exudate from acute meningitis. 



Though facultative, still its parasitic nature is so 

 dominant that it can only be cultivated with difficulty 

 and uncertainty. The most satisfactory medium for its 

 isolation in pure culture from the diseased meninges is 

 coagulated blood-serum (Loffler's mixture), and even here 

 one is not successful with each attempt. So uncertain is 

 its growth under artificial conditions that it is always advis- 

 able to inoculate a number of tubes with relatively large 

 quantities of the exudate, and even then growth often occurs 

 in only a part of them, notwithstanding the fact that on 

 microscopic examination the organism may have been 

 readily detected in large numbers in the exudate. Illus- 

 trative of this difficulty, the following experience of Council- 

 man, Mallory , and Wright may properly be quoted i 1 



"As showing the difficulty in growing the organisms in 

 cultures made from the meninges at the postmortem exami- 

 nation, ten cultures were made in one case from the exuda- 

 tion on the brain and six from the cord, cover-slip exami- 

 nations showing abundant organisms in the cells. Only 



1 See Epidemic Cerebrospinal Meningitis, etc., Report of the State Board 

 of Health, Mass., 1898, by Councilman, Mallory, and Wright. 



