DIPHTHERIA 191 



pathogenic power may occur in the fauces of convalescence 

 from the disease, and that possibly the bacilli of low patho- 

 genic power which have been described by various observers 

 may have in this way been produced from the true diph- 

 theria bacillus. They also found that cultures of diphtheria 

 obtained from false membrane which had been kept by 

 them in a dry condition for some months grew readily, 

 but were destitute of virulence. 



Dr. R. T. Hewlett and H. Nolan, of the British Institute 

 of Preventive Medicine, have published {British Medical 

 Journal, February 1, 1896) the results of the examination 

 of 1,000 tubes of Loffler's blood serum medium inoculated 

 from suspected cases of diphtheria. Of the 1,000 cases 

 examined, 587 were found to contain the diphtheria bacillus, 

 in 409 cases it was not found, and in 4 cases bacilli 

 were observed, as to the identity of which with the Klebs- 

 Loffler bacillus, or the distinction therefrom, they were 

 unable to satisfy themselves. Thus 58*7 per cent, of the 

 cases were true diphtheria. In 40*9 per cent., or about 

 two-fifths, of the cases the diphtheria bacillus was not 

 found, and the majority of these were probably not diph- 

 theria. In 25 cases no growth appeared on the surface of 

 the blood serum. In 600 cases they kept notes as to the 

 other organisms present in the cultivations. In 216 cases 

 they found the Klebs-Loffler bacillus present alone, while 

 in 247 it was absent, and in the remaining 137 cases they 

 found the true diphtheria bacillus associated with other 

 organisms, micrococci, not streptococci, predominating. 



Messrs. Hewlett and Nolan also draw attention in their 

 paper to the possibility of error owing to the swab having 

 been rubbed on a small area of the throat, also to the 

 ' crowding out ' of the bacilli, which may occur owing to 

 the presence of common saprophytes, or, again, to the 

 destruction of the bacilli by the use of antiseptics. Viru- 



