460 BACTERIA IN DIPHTHERIA. 
foci are found in the liver and spleen, and the mesenteric glands are en- 
larged, but the intestine presents a healthy appearance. But when cultures 
ave introduced into the alimentary canal the characteristic diphtheritic in- 
flammation of the mucous membrane of the intestine is induced. This re- 
sult was obtained both by direct injection into the lumen of the intestine 
and by injecting cultures into the mouth. 
Additional Notes upon Diphtheria and the Diphtheria Bacil- 
lus.—C. Frankel (1895) reports that he has repeatedly observed 
branching forms of the diphtheria bacillus in cultures upon Léf- 
fler’s blood-serum medium, and that these branching forms are seen 
more constantly and in greater numbers in cultures made upon the 
surface of hard-cooked albumen from hen’s eggs. 
The continued presence of virulent diphtheria bacilli in the fauces 
of patients who have recovered from the disease, either after the use 
of the antitoxin or under other treatment, has been demonstrated by 
several bacteriologists. Silverschmidt (1895), in forty-five cases 
treated by Behring’s antitoxic serum, found that the number of ba- 
cilli usually diminished some days after the treatment was com- 
menced, but that in cases in which complete recovery had taken 
place not infrequently virulent bacilli could be obtained many days 
(in one case thirty-one days) after convalescence was established. 
Escherich (1893) opposes the view that the pseudo-diphtheria bacil- 
lus is simply a non-virulent variety of the diphtheria bacillus. He 
found this pseudo-diphtheria bacillus in the throats of thirteen out 
of three hundred and twenty individuals examined. According to 
him there is no evidence that this completely non-virulent pseudo- 
diphtheria bacillus ever acquires pathogenic virulence, while attenu- 
ated varieties of the true diphtheria bacillus readily recover their 
power to produce the toxic products upon which virulence depends. 
Sevestre (1895), as a result of researches made by himself and 
several other bacteriologists who have made similar investigations, 
arrives at the conclusion that: 
“First. In a certain number of cases the bacillus of Léffler disap- 
pears about the same time as the false membranes; or it may persist 
for some time, but ceases to be virulent—in this case it seems to have 
undergone modifications and presents the form of short bacilli. . . . 
“Second. In another series of cases, less numerous but neverthe- 
less considerable, the bacillus persists in a virulent condition for a 
longer or shorter time after the apparent cure of the malady. . 
“Third. The observations collected up to the present time do not 
enable us to fix precisely the limits of persistence, but it is not far 
out of the way if we place it at several weeks to a month for the 
throat. In the nasal fossee the bacillus often persists for a still 
longer time, and its presence commonly coincides with a more or less 
abundant discharge from the nose.” 
