OTHEK ORGANISMS IN PNEUMONIA 



243 



pared a vaccine containing the three prevalent types of the pneumococcus. 

 In the latest applications of the method three injections at seven-day 

 intervals of, in all, 7000 million bacterial bodies, killed by an antiseptic, 

 were administered. A very marked diminution in the incidence of the 

 disease has followed. 



Methods of Examination. — In stained films of sputum, pus, 

 or other exudate containing pneumococci, the outstanding feature 

 is the predominance of diplococcal forms the elements of which 

 may have a lanceolate shape and which are Gram-positive. 

 Often a capsule stain demonstrates the capsule in such material, 

 and it may even appear stained in Gram films. Cultures on 

 blood agar should be made which after 24 hours at 37° C. will, 

 if the pneumococcus be present, show characteristic colonies. 

 Subcultures on serum bouillon or serum-smeared agar will show 

 capsulation. Bile-solubility and reaction with inulin may be 

 tested; if advisable a white mouse may be inoculated to test 

 the pathogenicity and to afford in blood films corroborative 

 evidence of capsulation. 



Occurrence of Other Organisms in Pneumonia. 



As might be expected, seeing that pneumonia is merely an 

 inflammation occurring 

 in a special tissue, or- 

 ganisms other than the 

 pneumococcus have been 

 found associated with 

 the disease, but in not 

 more than about 5 per 

 cent, of cases in all. 

 The chief of these are 

 the streptococcus pyo- 

 genes, b. influenzae, 

 Friedlander's pneumo- 

 bacillus, b. coli (rarely) ; 

 mixed infections with 

 these and with the 

 pneumococcus also 

 occur. Of the organisms Flo- 62. — Friedlander's pneumobaeillus, show- 

 \ ,i ing the variations in length, also capsules, 



named me pneumo- Film pre p ara tion from exudate in a case of 

 bacillus is of historic in- pneumonia, x 1000. 

 terest, as it was the first 



organism described in pneumonia, though there is little doubt 

 that in early days it was often confused with the pneumococcus. 



