A treatise on the principles and practice of medicine . ate, encap-sulated diplococcus; it is easily seen in cover slips, it readily stains bythe Gram method, and presents many cultural variations. Its atriumin pneumonia is the respiratory tract, although it may enter the bloodby other avenues in sepsis (q. v.). From the lung it may spread diffusely,chiefly through the bloodvessels. It is found in dust, saliva, and in 30per cent, of healthy noses and throats, though usually with attenuatedvirulence. Experimental inoculation has produced pericarditis, endo-carditis and empyema. In lobar pneumon
A treatise on the principles and practice of medicine . ate, encap-sulated diplococcus; it is easily seen in cover slips, it readily stains bythe Gram method, and presents many cultural variations. Its atriumin pneumonia is the respiratory tract, although it may enter the bloodby other avenues in sepsis (q. v.). From the lung it may spread diffusely,chiefly through the bloodvessels. It is found in dust, saliva, and in 30per cent, of healthy noses and throats, though usually with attenuatedvirulence. Experimental inoculation has produced pericarditis, endo-carditis and empyema. In lobar pneumonia or apart from this acutebacteriemia the pneumococcus has been found in the blood, joints, brain,bone-marrow, etc.; in otitis media, endocarditis, peritonitis, cholangitisand endometritis; in the urine and feces; in the nasal sinuses; and itmay pass from the mother to the fetus. It may be a terminal septicinfection. Until recently it was thought that typhoid and pneumoniawere local infections and that bacteriemia was a serious complication; PLATE II. L. SCHMIDT, FEC. The Diploeoeeus Pneumoniae, Stained With Methylene Blueand Fuehsin as a Counterstain. Taken from the Sputum of aCase of Acute Croupous Pneumonia. (Simon.; PNEUMONIA 63 the typhoid bacillus is found in the blood in 100 per cent, of early typhoidsand the pneumococcus in from 90 to 100 per cent, of pneumonics (v. i.).It is assumed that a pneumotoxin exists producing the toxemia; when anantitoxin develops, the crisis occurs, but the factors of resistance to,and recovery from, pneumonia are not known. Immunity does notresult from one attack; recurrence is likely in 23 per cent.; ten, eventwenty-eight recurrences are known. The pneumococcus is the solecause of typical pneumonia, but other microorganisms are sometimesfound, as the pneumobacillus (Friedlander), and the typhoid, colon,diphtheria, proteus, influenza, plague, and pyogenic organisms. Indirect Causes.—(a) Age.—Pneumonia may develop even in the new-born. P
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