STUDIES IN ANTISEPTICS (II)

whichl from the application in parallel of the ordinary methods of examination without preliminary incubation the existence of pure cultures of the meningococcus was suggested, it was at first difficult to resist the conclusion that contamination must have occurred. And the presence of the involution forms, and of organisms of a diplitheroidal form, made this conclusion doubly difficult to resist. Increasing experience, however, of the value of preliminary incubation of the body fluids in cerebro-spinal fever before inoculation of laboratory media-in attempting to determine their true bacterial content-soon enabled us to refute the frequently made suggestion of contamination as being merely the outcome of inexperience of the method. And this conviction was greatly strengthened by finding that the same tvpes of organisms simultaneously occurred again and again in increasing numbers of cases, and tllis largely irrespective of whetlher the fluid examined was cerebrospinal fluid, blood, or urine. Moreover, tlle apparent existence of pleomorphism, although, as we lhave said, not absolutely proved by cuLlture from single individuals, showed itself so constantly in subctilturinig from single colonies as practically to exclude the possibility of perpetually recurring contamination with the same organisms. And, finally, the suggestion of contamination we have again found to be quite inadequate to explain the results obtained by repeating the observations with a fresh series of 18 specimens of cerebro-spinal fluid in the summer of 1915. Of these 18 specimens 6 were submitted to filtration, a new Chamberland bougie beina in eaclh case employed, and in the majority of tlle specimens, filtered aDd uifiltered, submuitted to complete examination tlle same essential results were obtained, and may be seen by referenlce to tlle full paper now in the press. The total numiiber of specimens examined amounts, tlherefore, to 64, of whiclh 11 were filtrates, a Chamberland F filter being employed in 8. TIme stage, tlherefore, we lhave now reaclhed is thisthlat the true bacterial content of thle body fluLids in this Llisease is by no means adequately represented by tlle tieningococcus. On the contrary-provided that these fluids are thoroughly examined by (1) study of the morplhology of their deposits in fresh and in incubated specimens, botlh filtered and unfiltered; (2) supplemented, after plating, by cultural and bioclhemical study in, or on, laboratory media inoculated witlh incubated material, filtered-and unfiltered; (3) injection of monkeys with the freslh filtrates-ample justification will be found for directly attacking the problem of the true ancestry of the ineningococcus. And I therefore propose to make this the next stage in the investigation of the etiology of the disease side by side with further cxperimental observations in monkeys.