45 



apparently sterile. After 48 hours no living pneumococci could 

 be recovered from the lesion or from the blood. 



The results shows that pneumococci do multiply at the seat 

 of inoculation, but very few gain access to the blood stream 

 and survive ; capsule formation takes place in the protected 

 mouse. 



General Conclusions. 



1 . A uniform technique for diagnosis of types of pneumococci 

 is desirable, and it should be based on the American methods, 

 except that whole broth culture might be used for the suspension. 



2. The American Types I, II and III ate serologically distinct, 

 and they occur in cases of lobar pneumonia in this country in 

 about the same proportions as in the United States. 



3. The American types, Ha and 11b, occur in cases of lobar 

 pneumonia next in order of frequency to the Types I and II. 



4. The American " Type IV " is responsible for cases of 

 lobar pneumonia in this country somewhat more frequently 

 than in America. 



5. " Type IV," including those strains which appear to be 

 related to Type II, such as the American IIa, IIb, &c, might be 

 designated Group IV, since it contains a large number of separate 

 types. These types might be distinguished by the letters of 

 the alphabet : thus, types IIa and IIb would become Group IVa 

 and Group IVb, and so on. 



6. Protection tests on mice confirm the serological independence 

 of the types of pneumococci. 



7. Protective sera act equally well, whether inoculated 

 subcutaneously or intraperitoneally, whether the test culture is 

 injected immediately after the serum or after an interval of 

 18 hours. The test culture should be administered intraperi- 

 toneally to ensure accuracy of dosage. 



8. Certain protection experiments are apparently not in 

 agreement with the bacteriotropic theory of Neufeld. 



9. The absorption experiments have shown that there is no 

 firm union between antigen and antibody, and no neutralisation 

 of the protective properties. 



10. I am of the opinion that further work is necessary before 

 a final conclusion can be drawn as to the mode of action of 

 antipneumococcal serum. 



