i82 THOMPSON YATES AND JOHNSTON LABORATORIES REPORT 
occurred in all tubes. The cultures were examined in the fresh state ; they consisted 
in all cases of growth of type B. As in the previous cases the growth shewed (a) the 
typical variations in shape, (b) the typical variations in size ; the variations in shape 
were club-shape, spherical, oval, lemon-shape ; the variations in size ranged from an 
extremely minute spherical organism to club-shaped forms, 5 m in lengih. The organ- 
ism grew in clumps and masses. In the glucose broth cultures there were, however, 
organisms of type A, in small numbers ; they exactly corresponded to variety 1 of type 
A, as described in Chapter III. 
From these cultures no subcultures were obtained ; primary cultures were 
injected into two guinea-pigs ; one ot these was killed by mistake three days after 
inoculation, when nothing abnormal was found ; the other was inoculated intraperitone- 
ally, April 6, and killed on May 13 ; nodules were found in the spleen, but the attempt 
to obtain cultures from these tailed. 
In addition to these four cases, three others were examined culturally in the 
usual manner ; in one case, the cultures were contaminated with an organism appar- 
ently staphylococcus epidermidis albus ; in the other two cases, no cultures were 
obtained. 
V. COMMENTARY 
In the four cases recounted the cultures isolated had the following charac- 
teristictics in common : — 
1. The variations in size. 
2. The variations in form. 
3. The appearance during culture or inoculation of a certain 
characteristic form described as A. 
4. The macroscopic appearance of the cultures. 
5. The pathogenic effect on animals. 
In case 1, the A forms were seen only in hanging-drop preparations from 
scrapings of the nodules ; on the appearances seen in such scrapings not much 
reliance can be placed, and it is only by comparing drawings of the A forms observed 
in this case with the appearance of A isolated in cultures in the other cases that I 
was able to decide their presence with confidence. Many very peculiar forms are to 
be seen in such scrapings, and certain types of A are sometimes closely simulated by 
red blood-cells, leucocytes, fat globules, and nuclei of epithelial cells. The examina- 
tion of scrapings from normal tissues, lymphatic glands, spleen, and breast tissue, has 
convinced me that deductions from such preparations in the case of carcinomata are 
exceedingly liable to fallacy. 
Similarly, in the case of attempted culture by immersing pieces of carcinomatous 
tissue in fluid media, elements of the tissue become free and disseminated in the 
medium, and again may give rise to false deductions unless corrected by control 
