3o6 MANUAL OF BACTERIOLOGY. 



cytes. The formation of fibrin produces the liver-like consoli- 

 dation or "hepatization." The diplococci can readily be 

 demonstrated by the Gram method in sections of pneumonic 

 lung, which are best stained by carmine and gentian-violet. 



The Micrococcus lanceolatus can be sometimes detected in 

 large numbers, occasionally almost unmixed with other bacteria, 

 in the rusty sputum of lobar pneumonia, often showing the 

 peculiar unstained capsule. On account of its liability to be 

 mixed with other forms of bacteria its presence in the sputum 

 of cases suspected of being pneumonia is not of very great 

 value in differential diagnosis, especially since it is so com- 

 monly present in the normal mouth. In a suspicious case 

 its appearance in sputum in nearly pure culture may be 

 significant. 



Cultures from the blood of cases of pneumonia, where a large 

 amount of blood is taken, have shown the presence of the 

 pneumococcus in a considerable proportion of the cases, es- 

 pecially when severe or fatal. 



Rosenow* found that with proper technic, using large 

 quantities of blood — 5 to 7 c.c. — the pneumococcus can be re- 

 covered from the blood in practically all cases of croupous 

 pneumonia, and this method may be employed with advantage 

 for diagnosis in obscure cases of the disease. Wolff found that 

 the pneumococcus is present in the blood in a large percentage 

 of cases even after crisis. 



The Micrococcus lanceolatus is often also the cause of 

 bronchopneumonia and of meningitis. WallsteinJ obtained 

 it in 15 out of 33 cases of primary, and in many cases of second- 

 ary bronchopneumonia. It produces inflammations in other 

 situations as well, the most important being pleuritis, pericar- 

 ditis, endocarditis and arthritis. The Micrococcus lanceolatus 



* Journ. Infectious Diseases. Vol. I., 1904. pp. 280-312. 

 iJourn. Infectious Diseases. Vol. III., 1906. pp. 446-451. 

 % Journ. Exper. Med. Vol. VI., 1905. pp. 391-400. 



