. Medical diagnosis for the student and practitioner. established tact that wide diner- shows latter. ences with respect to virulence and the conferring of immunity exist in members of the pneumococcus group has served toexplain much that was obscure and apparently contradictory in and statistical studies of this disease. We now recognize the existence of various strains possessing certaincultural characteristics in common yet varying sufficiently in their reactionsto the sera of immunized animals to permit accurate classification anddifferentiation. Limitations of space
. Medical diagnosis for the student and practitioner. established tact that wide diner- shows latter. ences with respect to virulence and the conferring of immunity exist in members of the pneumococcus group has served toexplain much that was obscure and apparently contradictory in and statistical studies of this disease. We now recognize the existence of various strains possessing certaincultural characteristics in common yet varying sufficiently in their reactionsto the sera of immunized animals to permit accurate classification anddifferentiation. Limitations of space forbid any extended discussion of this great advancein our knowledge of lobar pneumonia which makes possible more accurate * It is readily stained as follows: (a) Make thin smear, dry in air and fix by heat. (b)Cover surface with the His stain (gentian violet, saturated alcoholic solution 5 plus95 distilled water, (c) Heat till steam rises, (d) Wash with copper sulphate solution(20 per cent.), (e) Dry and mount. The germ is 3^4 MEDICAL DIAGNOSIS Three stages. diagnosis, a better understanding of transmissibility, epidemiology, virulence,immunity, treatment and mortality. The table appended shows the classification at present in use at the Rocke-feller Institute. Adequate laboratory service is essential. Determination- of Pneumococcus Types by Agglutination Pneumococcus suspension Serum I(1:20) Serum II undiluted Serum II(1:20) + + + + Serum III . (1:5) + + Type + + Type II . - Subgroups II a, b, x. - Type III Type IV - Incubation for 1 hour at 37°C. The incidence and mortality in ioo cases at the same institution areshown in the following table: Incidence of Various Types of Pneumococci and Resulting Mortality Type of pneumococcus Incidence, per cent. Mortality, par cent. I 33 25 II 3i 32 III 12 45 IV 24 16 MORBID ANATOMY.—Three stages of the disease are recognized forpurposes of clinical convenience,
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1922
