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Upon injecting cultures from this sputum into guinea-pigs, the latter died in one-quarter of the time that it usually took them to succumb to a similar dose of an ordinary culture of the pneumococcus.
In those parts of the lungs that are not used, slimy secretions accumulate, irritating the air cells and other tissues, which become inflamed and begin to decay. Thus a luxuriant soil is prepared for the tubercle bacillus, the pneumococcus and other disease-producing bacilli and germs.
In defense of this last it may be pointed out that dental bacteriologists have now already isolated and described some thirty different forms of organisms which inhabit the mouth and teeth; and the pneumococcus may well be one of these.
Infection with the staphylococcus albus, the streptococcus, or the pneumococcus also causes a mild form of osteomyelitis which may go on to suppuration. It occurs in adults, being met with up to the age of fifty or sixty, and is characterised by the insidious development of a swelling which involves a considerable extent of a long bone.
This is vividly supported by the fact brought out in our later investigations of the sputum of slum-dwellers, carried out by city boards of health, that the percentage of individuals harboring the pneumococcus steadily increases all through the winter months, from ten per cent in December to forty-five, fifty, and even sixty per cent in February and March.
Widely present as the pneumococcus is, we know well that it is powerless for harm except in unhealthful surroundings. There is another interesting feature of its life history which is of practical importance, and that is, like many other bacilli it is increased in virulence and infectiousness by passing through the body of a patient.
Another interesting feature about the pneumococcus is its vitality outside of the body. If the saliva in which it is contained be kept moist, and not exposed to the direct sunlight and in a fairly warm place, it may survive as long as two weeks. If dried, but kept in the dark, it will survive four hours. If exposed to sunlight, or even diffuse daylight, it dies within an hour.
Suppuration, or the formation of pus, is one of the results of the action of bacteria on the tissues. The invading organism is usually one of the staphylococci, less frequently a streptococcus, and still less frequently one of the other bacteria capable of producing pus, such as the bacillus coli communis, the gonococcus, the pneumococcus, or the typhoid bacillus.
No better illustration could probably be given of the danger of drawing conclusions when you are not in possession of all the facts. One thing was entirely overlooked in all this speculation until about twenty years ago, that pneumonia was due not simply to the depressing effects of cold, but to a specific germ, the pneumococcus of Fraenkel.
Netter has observed the case of transmission of pneumonia from a mother to a fetus, and has seen two cases in which the blood from the uterine vessels of patients with pneumonia contained the pneumococcus. Wallick collected a number of cases of pneumonia occurring during pregnancy, showing a fetal mortality of 80 per cent.
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