DIPLOCOCCUS PNEUMONIA 95 



the nose or mouth. It enters the air passages and 

 penetrates to the finer parts of the lungs, there setting 

 up a rather characteristic inflammation. In certain 

 types of pneumonia the disease may involve whole 

 lobes; again, small patches here and there may be 

 involved, the intervening tissue being practically 

 normal. From the lungs the bacteria naturally pene- 

 trate into the blood stream. This emphasizes the fact 

 that while pneumonia expresses itself chiefly in the 

 lungs, it is in reality a general infection. It should, 

 moreover, be included among the transmissible infec- 

 tions because it appears in epidemics and definite 

 instances of communication directly from the sick to 

 the well are known. 



By reason of the spread of pneumococci through the 

 blood, complications in the form of involvement of 

 nearly every tissue in the body may result. The 

 interior of the heart, the pleura, and the meninges 

 are most commonly affected. 



For diagnosis bacteriologically, cultures are made 

 from the sputum, selecting the blood-streaked speci- 

 mens, and of the blood. Sputum should be dis- 

 infected by receiving it directly in 5 per cent, car- 

 bolic solution. If cloths are used to wipe the mouth, 

 they should be burned. This is the chief method for 

 protecting the well. Rinsing the throat with a mild 

 antiseptic is advisable both for patients and nurses. 



The coccus belongs properly to the streptococci, 

 since it divides only in one plane, and its cultures may 

 appear in chains. It has the peculiarities of growing in 

 an oval shape in pairs, with the distal ends pointed 

 (lance-shape), and being surrounded by a capsule. 



