336 Pneumonia 



organs present nothing characteristic by which they can be 

 recognized by macroscopic examination. 



The pneumococcus is not infrequently discovered in dis- 

 eased conditions other than croupous pneumonia; thus, Foa, 

 Bordoni-Uffreduzzi, and others found it in cerebro-spinal 

 meningitis; Frankel, in pleuritis; Weichselbaum, in perito- 

 nitis; Banti, in pericarditis; numerous observers in acute 

 abscesses; Gabbi isolated it from a case of suppurative 

 tonsillitis; Axenfeld observed an epidemic of conjunctivitis 

 caused by it; Zaufal, Levy, and Schroder and Netter have 

 been able to demonstrate it in the pus of otitis media, and 

 Foulerton and Bonney* isolated it from a case of primary 

 infection of the puerperal uterus. It has also been found 

 in arthritis following pneumonia, and in primary arthritis 

 without previous pneumonia by Howard. | 



Interesting statistics concerning the relative frequency of 

 pneumococcus infections in adults given by Netter { are as 

 follows : 



Pneumonia 65.95 



Broncho-pneumonia 15.85 



Meningitis 13.00 



Empyema 8.53 



Otitis media 2.44 



Endocarditis 1 .22 



Hepatic abscess 1 .22 



In 46 consecutive pneumococcus infections of children 

 he found : 



' ^ 



Otitis media 29 



Broncho-pneumonia 12 



Meningitis 2 



Pneumonia 1 



Pleurisy 1 



Pericarditis 1 



Susceptibility. Not all animals are susceptible to the 

 action of the pneumococcus. Guinea-pigs, mice, and rab- 

 bits are highly sensitive, dogs comparatively immune. 



Specificity. The etiologic relationship of the pneumo- 

 coccus to pneumonia is based more upon the frequency 

 with which it is found in that disease than upon its ability 

 to produce a similar affection in the lower animals, and we 

 are still unable to furnish an absolute proof of specificity 



* "Trans. Obstet. Soc. of Lond.," 1903, part n, p. 128 

 f "Johns Hopkins Hospital Bulletin," Nov., 1903. 

 J "Compte-rendu," 1889 



