Renal Function in Acute Nephritis. 



85 



individuals." The high percentage may be partly accounted for 

 by the fact that eleven of these had been or were in contact with 

 pneumonia cases of Types I and II. Stillman 1 reported a series 

 of three hundred and ninety-eight "normal individuals," finding 

 pneumococcus in one hundred and seventy-two (43.2 per cent.). 

 The specimens examined by us were not, strictly speaking, from 

 normal mouths; but inasmuch as these cases were in the hospital 

 because of conditions unassociated with respiratory affections, 

 it seems quite fair to compare the results with those reported by 

 Dochez, Avery and Stillman. Stillman's figures contain a greater 

 proportion of Types I, II and III than do ours, but most of the 

 individuals harboring Types I and II were "contacts." In our 

 series, only one of whom was known to be a "contact," the virulent 

 types were relatively uncommon, 73.8 per cent, of the cases 

 harboring Type IV pneumococci. There is apparently a con- 

 siderable variation in the incidence of pneumococci in the mouths 

 of normal individuals at different seasons, in different years and 

 in different groups, and among the individuals harboring pneumo- 

 cocci considerable variation in the proportion of the four types. 



Summary. — During 1916 and 191 7 pneumococci were recovered 

 from the mouths of 32.2 per cent, of surgical cases before operation. 

 Type I was found in .6 per cent, of the cases harboring pneumo- 

 cocci, Type II in 1.2 per cent., an Atypical II in 11. 2 per cent., 

 Type III, in 13 per cent, and Type IV in 73.8 per cent. 



160 (1338) 



Renal action in acute nephritis. 



By Dana W. Atchley (by invitation). 



{From the Coolidge Fellowship and the Medical Clinic, Presbyterian 

 Hospital, Columbia University, New York.} 



The clinical discussion of these cases will appear with the func- 

 tional results in a later paper. In the series are six acute cases 

 and two cases entering the hospital in an acute attack but giving 

 a history of previous renal disease. The phenolsulphonphthalein 

 excretion, the renal test day, the blood urea, the urea index and 

 the chloride index were employed for the functional studies. The 



1 Stillman, E. G., Jour. Exp. Med., 1916, XXIV, 651. 



