228 INFLAMMATION AND SUPPURATION 



times swollen at one end, and measuring about 1 *5 /u, in length 

 and rather less than '5 //, in thickness. It stains readily with 

 the basic aniline dyes and retains the stain in Gram's method. 

 In cultures it grows best under anaerobic conditions, for example 

 in deep tubes of 2 per cent, glucose agar, and the reaction of the 

 medium ought to be distinctly acid. In such a medium after 

 three or four days' incubation at 37 C. small whitish colonies 

 appear, which when examined under a low magnification are 

 seen to have a lenticulate shape. The organism shows con- 

 siderable pleomorphism, coccoid, diphtheroid, and filamentous 



types being present, as 

 well as irregular bizarre 

 forms. Some observers 



. have also obtained sur- 



_^ face growth on ordinary 



agar, especially after the 



I v ^ai O1 'g an i sm h as been culti- 



vated for some time under 

 "^f-l anaerobic conditions. Its 



relation to the suppura- 



/s tion in acne has been a 



matter of dispute, some 

 holding that it is the cause 

 of the suppuration, whilst 

 others maintain that this 

 is due to pyogenic cocci. 



, There seems, however, to 

 FIG. 61. Film preparation of conjunctiva! . .. , , ' , ' 

 secretion, showing the Morax diplo-bacillus be W** 6 doubt that the 

 of conjunctivitis, x 1000. bacillus is sometimes pre- 



sent alone. 



Acute Rheumatism. There are many facts which point to 

 the infective nature of this disease, and investigations from this 

 point of view have yielded important results. Of the organisms 

 isolated, the one which appears to have strongest claims is a 

 small coccus observed by Triboulet, and by Westphal and 

 Wassermann, the characters and action of which were first 

 investigated in this country by Poynton and Paine. It is now 

 usually spoken of as the m^crococc^s rheumaticus. The organism 

 is sometimes spoken of as a diplococcus, but it is best described 

 as a streptococcus growing in short chains ; in the tissues, how- 

 ever, it usually occurs in pairs. It is rather smaller than the 

 streptococcus pyogenes, and although it can be stained by Gram's 

 method, it loses the colour more readily than the streptococcus. 

 In the various media it produces a large amount of acid, and 



