Manual of bacteriology

Front matter

BIOLOGY

LIBRARY

G

Preface To The Sixth Edition

WE have taken advantage of the publication of a new edition to make again a careful revision of the whole work. During the past two years definite additions to our knowledge have been made in various departments, and in dealing with these we have directed attention chiefly to those results which appear to us likely to stand the test of future inquiry. In view of our purpose to produce a book which will be primarily useful to students and practitioners of medicine, any increase in its size is undesirable; but the growing recognition of the importance of the fungi as disease-producing organisms has led us to add a chapter dealing with this subject. For assistance in its preparation, it gives us pleasure to record our indebtedness to Professor Percy Groom of the Imperial College of Science, London, and to Dr. Cranston Low, Edinburgh. A new section on the bacteriology of milk has also been added. A number of new micro-photographs have been inserted throughout the text.

392527

Preface To The First Edition

THE science of Bacteriology has, within recent years, become so extensive, that in treating the subject in a book of this size we are necessarily restricted to some special departments, unless the description is to be of a superficial character. Accordingly, as this work is intended primarily for students and practitioners of medicine, only those bacteria which are associated with disease in the human subject have been considered. We have made it a chief endeavour to render the work of practical utility for beginners, and, in the account of the more important methods, have given elementary details which our experience in the practical teaching of the subject has shown to be necessary.

In the systematic description of the various bacteria, an attempt has been made to bring into prominence the evidence of their having an etiological relationship to the corresponding diseases, to point out the general laws governing their action as producers of disease, and to consider the effects in particular instances of various modifying circumstances. Much research on certain subjects is so recent that conclusions 'on many points must necessarily be of a tentative character. We have, therefore, in our statement of results aimed at drawing a distinction between what is proved and what is only probable.

In an Appendix we have treated of four diseases ; in two of these the causal organism is not a bacterium, whilst in the other two its nature is not yet determined. These diseases 'Jhave been

vii viii PREFACE TO THE FIRST EDITION

included on account of their own importance and that of the pathological processes which they illustrate.

Our best thanks are due to Professor Greenfield for his kind advice in connection with certain parts of the work. We have also great pleasure in acknowledging our indebtedness to Dr. Patrick Manson, who kindly lent us the negatives or preparations from which Figs. 174-179 have been executed.

As we are convinced that to any one engaged in practical study, photographs and photomicrographs supply the most useful and exact information, we have used these almost exclusively in illustration of the systematic description. These have been executed in the Pathological Laboratory of the University of Edinburgh by Mr. Richard Muir. The line drawings were prepared for us by Mr. Alfred Robinson, of the University Museum, Oxford.

To the volume is appended a short Bibliography, which, while having no pretension to completeness, will, we hope, be of use in putting those who desire further information on the track of the principal papers which have been published on each of the subjects considered.

Chapter I. General Morphology And Biology

PAGE

INTRODUCTORY — Terminology — Structure of the bacterial cell — Reproduction of bacteria — Spore formation — Motility — Minuter structure of the bacterial protoplasm — Chemical composition of bacteria — Classification — Food supply — Relation of bacteria to moisture, gaseous environment, temperature, and light — Conditions affecting bacterial motility — Effects of bacteria in nature — Methods of bacterial action — Variability among bacteria . . . . .1

Chapter II. Methods Of Cultivation Of Bacteria

Introductory — Methods of sterilisation! — Preparation of culture media — Use of the culture media — Methods of the separation of aerobic organisms — Principles of the culture of anaerobic organisms — Miscellaneous methods — General laboratory rules . . . . . . . . .26

Chapter III. Microscopic Methods

The microscope — Examination of hanging-drop cultures — Film preparations— Examination of bacteria in tissues — The cutting of sections — -Staining principles — Mordants and decolorisers — Formulae of stains — Gram's method and its modifications — Stain for tubercle and other acid- fast bacilli — Staining of spores, capsules, and flagella — The Romanowsky stains . 92

CONTENTS

Chapter IV

EXAMINATION OF SERUM — PREPARATION OF VACCINES — GENERAL BACTERIOLOGICAL DIAGNOSIS — INOCULATION OF ANIMALS.

PAGE

Observation of agglutination and sedimentation — Opsonic methods — Method of measuring the phagocytic capacity of the leucocytes— Bactericidal methods — Hsemolytic tests — Fixation and deviation of complement — Wassermaim reaction — Preparation of vaccines — Wright's method of counting bacteria in dead cultures— General bacteriological diagnosis — Routine procedure — Inoculation of animals — Autopsies on animals . .118

Chapter V. Bacteria In Air, Soil, Water, Milk — Antiseptics

AIR : Methods of examination. SOIL : Methods of examination — Varieties of bacteria in soil. WATER : Methods of examination —Bacteria in water — Bacteriology of sewage. MILK : Souring of milk — Pathogenic organisms in milk — Sterilisation of milk. ANTISEPTICS : Methods of investigation — The action of antiseptics—Certain particular antiseptics .... 149

Chapter VI

RELATIONS OF BACTERIA TO DISEASE — THE PRODUCTION OF TOXINS BY BACTERIA.

Introductory — Conditions modifying pathogenicity — Modes of bacterial action — Tissue changes produced by bacteria — Local lesions — General lesions — Disturbances of metabolism by bacterial action — The production of toxins by bacteria, and the nature of these — Allied vegetable and animal poisons — The theory of toxic action . . . .181

Chapter VII. Inflammatory And Suppurative Conditions

The relations of inflammation and suppuration — The bacteria of inflammation and suppuration — Experimental inoculation- — Lesions in the human subject — Mode entrance and spread of pyogenic bacteria — Ulcerative endocarditis — Acute suppur-

CONTENTS xi

PAQB

ative periostitis — Erysipelas — Conjunctivitis — Acute rheumatism— Vaccination treatment of infections by the pyogenic cocci — Methods of examination in inflammatory and suppurative conditions ..... 206

Chapter. VIII

INFLAMMATORY AND SUPPURATIVE CONDITIONS, continued : THE ACUTE PNEUMONIAS, EPIDEMIC CEREBRO-SPINAL MENINGITIS

Introductory — • Historical — Bacteria in pneumonia — Fraenkel's pneumococcus — Friedlaender's pneumobaccillus — Distribution of pneumobacteria — Experimental inoculation — Pathology of pneumonia — Methods of Examination. Epidemic cerebro-spinal meningitis — Serum reactions — Allied diplococci . . 232

Chapter IX. Gonorrhcea And Soft Sore

The gonococcus — Microscopical characters— Cultivation — Comparison with meningococcus — Relations to the disease — Its toxin — Distribution — Gonococcus in joint affections — Methods of diagnosis. SOFT SORE : Microscopical characters and cultivation of bacillus , 259

Chapter X. Tuberculosis

Historical — Tuberculosis in animals — Tubercle bacillus — Staining reactions — Cultivation of tubercle bacillus — Powers of resistance— Action on the tissues — Histology of tuberculous nodules — Distribution of bacilli — Bacilli in tuberculous discharges — Experimental inoculation — Varieties of tuberculosis — Other acid-fast bacilli — Action of dead tubercle bacilli — Sources of human tuberculosis — Specific reactions of the tubercle bacillus — Tuberculins — Phenomena of supersensitiveness — Tuberculin reactions — Toxins of the tubercle bacillus — Immunity phenomena in tuberculosis— Therapeutic application of the tuberculins — Active immunisation associated with opsonic observations — Antitubercular sera — Methods of examination . 271 xii CONTENTS

Chapter XI. Leprosy

PAGE

Pathological changes — Bacillus of leprosy — Position of the bacilli

— Relations to the disease — Methods of diagnosis . . 306

Chapter XII. Glanders And Rhinoscleroma

GLANDERS : The natural disease— The glanders bacillus — Cultivation of glanders bacillus — Powers of resistance — Experimental inoculation — Action on the tissues — Mode of spread — Serum reactions — Mallein ^and its preparation — Methods of examination— RHINOSCLEROMA . 316

Chapter XIII. Actinomycosis And Allied Diseases

Characters of the actinomyces — Tissue lesions — Distribution of lesions — Cultivation of actinomyces — Varieties of actinomyces and allied forms — Experimental inoculation — Methods of examination and diagnosis — Madura disease . . . 327

Chapter XIV. Anthrax

Historical summary — Bacillus anthracis — Appearances of cultures — Biology — Sporulation — Natural anthrax in animals — Experimental anthrax — Anthrax in man — Pathology — Toxins of the bacillus anthracis — Mode of spread in nature — Immunisation of animals against anthrax — Methods of examination . 341

Chapter XV. Typhoid Fever— Bacilli Allied To The Typhoid Bacillus

Introductory — Bacillus coli communis — Culture reactions — Isolation and recognition of B. coli — Pathogenic properties — Bacillus typhosus — Isolation and appearances of cultures —

CONTENTS xiii

PAGE

Biological reactions — Pathological ^changes in typhoid fever- Immunisation of animals — Etiological relationships of bacillus typhosus — Epidemiology of typhoid fever — Typhoid carriers — Serum diagnosis of typhoid fever — Vaccination against typhoid — Methods of examination — Paratyphoid and food-poisoning bacilli — 'The bacillus paratyphosus — Bacillus enteritidis (Gaertner) — The psittacosis bacillus — Danysz's bacillus and rat viruses — Bacillus dysenterise — Bacillus enteritidis sporogenes — Summer diarrhrea — General review of coli-typhoid group — Mutation in coli-typhoid bacilli . . .361

CHAPTEK XVI.

DIPHTHERIA.

Historical — General facts — Bacillus diphtherise — Microscopical characters — Distribution — Association with other organisms — Cultivation — Powers of resistance — Inoculation experiments — The toxins of diphtheria — Variations in virulence of bacilli — Bacilli allied to the diphtheria bacillus — Summary of pathogenic action — Methods of diagnosis .... 409

CHAPTEE XVII.

TETANUS— OTHER ANAEROBIC BACILLI.

Introductory — Historical — Bacillus tetani — Isolation of bacillus tetani — Characters of cultures — Conditions of growth — Pathogenic effects — Experimental inoculation — Tetanus toxins — Antitetanic serum — Methods of examination — Malignant cedema — Characters of bacillus — Experimental inoculation — Methods of diagnosis — Bacillus botulinus — Quarter-evil — Bacillus aerogenes capsulatus — Fusiform anaerobic bacilli . 428

CHAPTER XVIII.

CHOLERA.

Introductory — The cholera spirillum — Distribution of the spirilla — Cultivation — Powers of resistance — Experimental inoculation — Toxins of cholera spirillum — Inoculation of human subject — Immunity — Methods of diagnosis — General summary — Other spirilla resembling the cholera organism — MetchnikofFs spirillum — Finkler and Prior's spirillum — Deneke's spirillum 459 xiv CONTENTS

CHAPTEE XIX.

INFLUENZA, WHOOPING-COUGH, PLAGUE, MALTA FEVER.

PAGE

INFLUENZA BACILLUS : Microscopical characters — Cultivation — Distribution— Experimental inoculation — Methods of examination. WHOOPING-COUGH BACILLUS : Microscopical characters — Pathogenic effects— Methods of examination. BACILLUS OF PLAGUE : Microscopical characters — Cultivation — Anatomical changes produced and distribution of bacilli — Experimental inoculation — Paths and mode of infection — Toxins, immunity, etc. — Preventive inoculation — Anti-plague sera — Methods of diagnosis. MALTA FEVER : Micrococcus melitensis — Relations to the disease — Mode of spread of the disease — Methods of diagnosis ........ 480

CHAPTEK XX.

DISEASES DUE TO SPIROCH^TES — THE RELAPSING FEVERS, SYPHILIS, AND FRAMBCESIA.

RELAPSING FEVER, : Characters of the spirochsete — Relations to the disease — Immunity. AFRICAN TICK FEVER : Transmission of the disease. SYPHILIS : Microscopic characters of spirochsete pallida — Distribution — Cultivation — Transmission of the disease — Serum Diagnosis — Wassermann reaction. FRAM- BCESIA or YAWS . . . 507

CHAPTER XXI.

PATHOGENIC FUNGI.

Botanical Description — Methods — Microspora — Trichophyta — Achoria — Thrush — Aspergillosis — Sporotrichosis — Blastomycosis — Microsporon furfur ..... 527

CHAPTER XXII.

IMMUNITY.

Introductory— Acquired immunity — Artificial immunity — Varieties — Active immunity — Methods of production — Attenuation and exaltation of virulence — Passive immunity — Action of the serum — Antitoxic serum — Standardising of toxins and of antisera — Nature of antitoxic action — Ehrlich's theory of the constitution of toxins — Antibacterial serum — Bactericidal and

CONTENTS xv

PAGE

lysogenic action — Haemolytic and other sera — Methods of the hsemolytic tests — Opsonic action — Agglutination — Precipitins — Therapeutic effects of anti-sera — Theories as to acquired immunity — Ehrlich's side-chain theory— Theory of phagocytosis — Natural immunity — Natural bactericidal powers — Natural susceptibility to toxins — Supersensitiveness or anaphylaxis — The serum disease in man 549

APPENDIX A.

SMALLPOX AND VACCINATION.

Jennerian vaccination — Relationship of smallpox to cowpox — Micro-organisms associated with smallpox — The nat ire of vaccination ...... 603

APPENDIX B.

HYDROPHOBIA.

Introductory — Pathology — The virus of hydrophobia — Prophylaxis

— Antirabic serum — Methods . .611

APPENDIX C.

MALARIAL FEVER.

The malarial parasite — -The cycle of the malarial parasite in man — The cycle in the mosquito — Varieties of the malarial parasite— General considerations — The pathology of malaria — Methods of examination C24

APPENDIX D.

AMCEBIC DYSENTERY.

Amoebic dysentery — Characters of the amoebae — Cultivation of the amoebae — Distribution of the amcebse — Experimental [inoculation— Methods of examination ... . 641 xvi CONTENTS

APPENDIX E.

TRYPANOSOMIASIS — LEISHMANIOSIS — PIROPLASMOSIS.

PAGE

THE PATHOGENIC TKYPANOSOME.S : Morphology and biology of the trypanosomata — Trypanosoma lewisi — Nagana or tse-tse fly disease — Trypanosome of sleeping sickness — Trypanosoma rhodesiense — Trypanosoma cruzi. LEISHMANIOSIS: Leishmania donovani — Leishmania infantum — Leishmania tropica — Histoplasma capsulation. PIROPLASMOSIS .... 650

APPENDIX F.

YELLOW FEVER ...... 677

APPENDIX G.

EPIDEMIC POLIOMYELITIS ..... 682

APPENDIX H.

PHLEBOTOMUS FEVER ..... 687

APPENDIX J.

TYPHUS FEVER ...... 689

INDEX . 719

LIST OF COLOURED PLATES.

PLATE I.

FIG.

1. Film of pus, containing staphylococci and streptococci.

2. Fraenkel's pneumococcus in sputum.

3. Meningococcus in epidemic cerebro- spinal fever.

4. Film from a scraping of throat in Vincent's angina, showing fusiform

bacilli and spirochaetes.

5. Gonorrhoaal pus, showing gonococci and staphylococci.

PLATE II.

6. Spirochaete pallida, case of congenital syphilis.

7. Tubercle bacillus and other bacteria in sputum.

8. Leprous skin, showing clumps of bacilli in the cutis.

9. Leprous granulation tissue, showing bacilli.

PLATE III.

10. Streptothrix actinomyces.

11. Anthrax bacilli.

12. Bacillus diphtherias.

13. Bacillus diphtheriae (involution forms).

14. Hofmann's pseudo-diphtheria bacillus.

15. Typhoid bacillus, showing flagella.

b xvii xviii LIST OF COLOURED PLATES

PLATE IV.

FIG.

16. Negri bodies in nerve cells in rabies.

17. Bacillus pestis (involution forms).

18. Spirochsete of relapsing fever.

19. The cholera spirillum, showing flagella.

20. Bacillus tetani, showing spores.

PLATE V.

21. The parasite of mild tertian malaria.

Cycle I. (Schizogony). Asexual cycle in the human blood. Cycle II. (Sporogony). Sexual cycle in the mosquito.

22. The parasite of malignant malaria.

PLATE VI.

23. Entamoeba histoly tica in pus, from tropical abscess of liver.

24. Leishman-Donovan bodies, from a case of kala-azar.

25. Trypanosoma gambiense.

LIST OF ILLUSTRATIONS IN TEXT.

1 . Forms of bacteria ... ] 3

2. Hot-air steriliser . . . . ... .28

3. Koch's steam steriliser . . . . . .28

5. Steriliser for blood serum . . . . .31

6. Meat press .... 32

7. Hot-water funnel . . . . . .36

8. Blood serum inspissator . . . . . .41

9. Cylinder of potato cut obliquely . . . . .46

10. Ehrlich's tube containing piece of potato . . .46

11. Apparatus for filling tubes . . . . .54

12. Tubes of media ....... 54

13. Platinum wires in glass handles . . . . .55

14. Method of inoculating solid tubes . . . .56

15. Rack for platinum needles . . . ... 56

16. Petri's capsule . . . . . . .58

17. Koch's levelling apparatus for use in preparing plates . . 59

18. Koch's levelling apparatus . . . . .59

19. Esmarch's tube for roll culture . . . . .61

20. Apparatus for supplying hydrogen for anaerobic cultures . 64

21. Esmarch's roll-tube adapted for culture containing anaerobes . 65

22. Bulloch's apparatus for anaerobic plate cultures . .65

23. M'Leod's capsule for anaerobic plating . . . .66

24. Flask for anaerobes in liquid media . . . .69

25. Flask arranged for culture of anaerobes which develop gas . 70

26. Tubes for anaerobic cultures on the surface of solid media . 70

27. Slides for hanging drop-cultures . . . . .71

28. Apparatus for counting colonies . . . . .72

29. Wright's 250 c. mm. pipette fitted with nipple . . .73

30. Geissler's vacuum pump for filtering cultures . . .77

31. Chamber-land's candle and flask arranged for filtration . . 77

32. Chamberland's bougie with lamp funnel . . . .78

xix xx LIST OF ILLUSTRATIONS IN TEXT

33. Bougie inserted through rubber stopper . . . .78

34. Muencke's modification of Chamberland's filter . . .79

35. Flask for filtering small quantities of fluid . . .80

36. Tubes for demonstrating gas-formation by bacteria . . 83

37. Geryk air-pump for drying in racuo . . . .87

38. Reichert's gas regulator . . . . . .88

39. Hearson's incubator for use at 37° C. . . .89

40. Cornet's forceps for holding cover-glasses . . .95

41. Needle with square of paper on end for manipulating paraffin

42. Syphon wash-bottle for distilled water . . . .103

43. Wright's 5 c. mm. pipette ..... 119

44. Tubes used in testing agglutinating and sedimenting properties

45. Wright's blood -capsule . . . . . .125

46. Test-tube and pipette arranged for obtaining fluids containing

47. Hollow needle for intraperitoneal inoculations . . . 145

48. Petri's sand filter . . . . . .150

49. Staphylococcus pyogenes aureus, young culture on agar,

50. Two stab cultures of staphylococcus pyogenes aureus in gelatin 209

51. Streptococcus pyogenes, young culture on agar. x 1000 . 210

52. Culture of the streptococcus pyogenes on an agar plate . . 211

53. Bacillus pyocyaneus ; young culture on agar. x 1000 . .215

54. Micrococcus tetragenus. x 1000 . . . .216

55. Streptococci in acute suppuration. x 1000 . . .219

56. Minute focus of commencing suppuration in brain. x 50 . 221

57. Secondary infection of a glomerulus of kidney by the staphylo-

coccus aureus. x 300 ..... 222

58. Section of a vegetation in ulcerativc endocarditis. x 600 . 224

59. Film preparation from a case of acute conjunctivitis, showing

the Koch-Weeks bacilli, x 1000 . . . .226

60. Koch-Weeks bacillus from a young culture on blood agar.

61. Film preparation of conjunctival secretion, showing the diplo-

bacillus of conjunctivitis. x 1000 .... 228

62. Film preparation of pneumonic sputum, showing numerous

pneumococci (Fraenkel's). x 1000 .... 235

63. Friedlander's pneumobacillus, from exudate in a case of

64. Fraenkel's pneumococcus in serous exudation. x 1000 . . 236

65. Stroke culture of Fraenkel's pneumococcus on blood agar . 237

66. Fraenkel's pneumococcus from a pure culture on blood agar.

LIST OF ILLUSTRATIONS IN TEXT xxi

67. Stab culture of Friedlander's pneumobacillus . . . 240

68. Friedlander's pneumobacillus, from a young culture on agar.

69. Capsulated pneumococci in blood taken from the heart of a

70. Film preparation of exudation from a case of meningitis, x 1000 251

71. Two day colonies of the meningococcus on Martin's medium.

72. Pure culture of diplococcus intracellularis . . . 253

73. Portion of film of gonorrhreal pus. x 1000 . . .260

74. Colonies of gonococcus on serum agar .... 261

75. Gonococci, from a pure culture on blood agar. x 1000 . 261

76. Film preparations of pus from soft chancre, showing Ducrey's

bacillus. xlSOO . . . . . .268

78. Tubercle bacilli, from a pure culture on glycerin agar. x 1000 273

79. Tubercle bacilli in phthisical sputum, x 1000 . . 274

80. Cultures of tubercle bacilli on glycerin agar . . . 277

81. Tubercle bacilli in section of human lung in acute phthisis.

82. Tubercle bacilli in giant-cells, x 1000 . . . 282

83. Tubercle bacilli in urine, x 1000 .... 283

84. Bovine tubercle bacilli in milk, x 1000 . . . 285

85. Cultures of bovine and human tubercle bacilli, 5 weeks old, on

glycerin egg ....... 286

86. Moeller's Timothy-grass bacillus, x 1000 . . .291

87. Cultures of acid- fast bacilli grown at room temperature . 291

89. Section through leprous skin, showing the masses of cellular

granulation tissue in the cutis. x 80 . . . 307

90. Superficial part of leprous skin, x 500 . . . 309

91. High-power view of portion of leprous nodule, showing the

arrangement of the bacilli within the cells of the granulation tissue. xllOO. . . . . . 310

92. Kedrowski's leprosy bacillus, x 1000 .... 311

93. Glanders bacilli from peritoneal exudate of guinea-pig. x 1000 318

94. Glanders bacilli, x 1000 . . . . .319

95. Actinomycosis of human liver. x 500 . . . 329

96. Actinomyces in human kidney. x 500 . . . 330

97. Colonies of actinomyces. x 60 . . . . 331

98. Cultures of the actinomyces on glycerin agar. x 60 . . 334

99. Actinomyces, from a culture on glycerin agar. x 1000 . 335

100. Shake cultures of actinomyces in glucose agar . . . 336

101. Section of a colony of actinomyces from a culture in blood xxii LIST OF ILLUSTRATIONS IN TEXT

102. Streptothrix Madurse. x 1000 .... 339

103. Surface colony of the anthrax bacillus on an agar plate.

104. Anthrax bacilli, arranged in chains, from a twenty-four hours'

culture on agar at 37° C. x 1000 .... 344

105. Stab culture of the anthrax bacillus in peptone-gelatin . 344

106. Anthrax bacilli containing spores. x 1000 . . . 346

107. Scraping from spleen of guinea-pig dead of anthrax. x 1000 349

108. Portion of kidney of a guinea-pig dead of anthrax, x 300 . 351

109. Bacillus coli communis. x 1000 .... 362

110. A large clump of typhoid bacilli in a spleen. x 500 . . 368

111. Typhoid bacilli, from a young culture on agar, showing some

filamentous forms, x 1000 ..... 369

112. Typhoid bacilli, from a young culture on agar, showing

113. Culture of the typhoid bacillus and of the bacillus coli . 371

114. Colonies of the typhoid bacillus in a gelatin plate. x 15 . 372

115. Film preparation from diphtheria membrane ; showing

numerous diphtheria bacilli, x 1000 . . .411

116. Section through a diphtheritic membrane in trachea, show-

ing diphtheria bacilli. x 1000 .... 412

117. Cultures of the diphtheria bacillus on an agar plate . . 414

118. Diphtheria colonies, two clays old, on agar. x8 . .414

119. Diphtheria bacilli from a twenty-lour hours' culture on

120. Diphtheria bacilli, from a three days' agar culture. x 1000 . 415

121. Involution forms of the diphtheria bacillus, x 1000 . . 416

122. Pseudo-diphtheria bacillus (Hofmann's). x 1000 . . 424

123. Xerosis bacillus from a young agar culture. xlOOO . . 425

124. Film preparation of discharge from wound in a case of

tetanus, showing several tetanus bacilli of "drumstick" form. xlOOO . . . . . .430

125. Tetanus bacilli, showing flagella. x 1000 . . .431

126. Spiral composed of numerous twisted flagella of the tetanus

bacillus. xlOOO . . . . . .432

127. Tetanus bacilli, some of which possess spores, x 1000 . 432

128. Stab culture of the tetanus bacillus in glucose gelatin . . 433

129. Colonies of the tetanus bacillus on agar seven days old. x 50 434

130. Film preparation from the affected tissues in a case of

malignant oedema, x 1000 ..... 447

131. Bacillus of malignant oedema, showing spores, x 1000 . 448

132. Stab cultures in agar — tetanus bacillus, bacillus of malignant

oedema, and bacillus of quarter-evil .... 449

133. Bacillus of quarter-evil, showing spores, x 1000 . . 455

134. Bacillus aerogenes capsulatus . . . . .456

LIST OF ILLUSTRATIONS IN TEXT xxiii

135. Cholera spirilla, from a culture on agar of twenty-four hours'

136. Cholera spirilla stained to show the terminal flagella. x 1000 461

137. Cholera spirilla from an old agar culture. x 1000 . . . 461

138. Puncture culture of the cholera spirillum . . . 463

139. Colonies of the cholera spirillum on a gelatin plate . . 464

140. Metchnikoff's spirillum. x 1000 .... 477

141. Puncture cultures in peptone-gelatin .... 478

142. Finkler and Prior's spirillum. x 1000 . . .479

143. Influenza bacilli from culture on blood agar. x 1000 . .480

144. Film preparation from a twenty-four hours' culture of the

whooping-cough bacillus. x 1000 .... 486

145. Film preparation from a plague bubo. x 1000 . . 489

146. Bacillus of plague from a young culture on agar. x 1000 . 490

147. Bacillus of plague in chains. x 1000 .... 490

148. Culture of the bacillus of plague on 4 per cent, salt agar.

149. Section of a human lymphatic gland in plague. x 50 . 493

150. Film preparation of spleen of rat after inoculation with the

bacillus of plague, x 1000 , 495

151. Micrococcus melitensis. x 1000 ... . . 503

152. Spirillum of relapsing fever in human blood, x about 1000 . 509

153. Spirillum Obermeieri in blood of infected mouse, x 1000 . 510

154. Film of human blood containing spirillum of tick fever.

155. Spirillum of human tick fever (Spirillum Duttoni) in blood of

infected mouse, x 1000 . . . . .514

156 and 157. Film preparations from juice of hard chancre showing

spirochsete pallida. x 1000 . .... 517

158. Film preparation from juice of hard chancre showing spirochsete

159. Section of spleen from a case of congenital syphilis, showing

spirochsete pallida. xlOOO. . . . .519

160. Spirochsete refringens. x 1000 . . . . 520

162. Hair infected with Microsporon Audouini. x 500 . . 533

163. Microsporon Audouini on Sabouraud's maltose agar . . 534

164. Trichophyton crateriforme and Trichophyton rosaceum on

Sabouraud's medium ...... 535

165. Hair infected with large-spored ringworm, x 500 . . 536

166. Favus hair, showing air channels left by mycelium. x 300 . 537

167. Achorion schonleinii on Sabouraud's maltose agar, and

cultures of Achorion quinckeanum .... 538

168. Scraping from favus scutula, showing spores and mycelium.

xxiv LIST OF ILLUSTRATIONS IN TEXT

169. Edge of living colony of Sporotrichon beurmanni. x 200 . 542

170. Film from agar culture of Sporotrichon beurmanni. x 1025 . 543

171. Growth of blastomyces in kidney of rabbit infected from

172. Double-contoured bodies in tissues from case of Rixford and

173. Microsporon furfur ; scraping from skin. x 1000 . . 547 174-179. Various phases of the benign tertian parasite . . 629 180-185. Exemplifying phases of the malignant parasite . . 630

186. Amoebae of dysentery ...... 642

187. Section of wall of liver abscess, showing an amoeba of spherical

form with vacuolated protoplasm, x 1000 . . .647

188. Trypanosoma brucei from blood of infected rat. Note in two

of the organisms commencing division of micronucleus and

undulating membrane, x 1000 .... 657

189. Trypanosoma gambiense from blood of guinea-pig. x 1000 660

190. Leishman-Donovan bodies from spleen smear. x 1000 . 669

191. Leishman-Donovan bodies within endothelial cell in spleen.

192. Histoplasma capsnlatum, section of liver, x 1000 . . 675

' x x-t

PLATE I.

Fio. 1. Film of pus, containing staphylococci and streptococci. Stained by Gram's method. x 1000 diameters.

FIG. 2. Fraenkel's pneumococcus in sputum, from a case of acute pneumonia. Rd. Muir's method of capsule staining.

FIG. 3. Meningococcus in epidemic cerebro-spinal fever, from lumbar puncture fluid, showing some involution forms. Leishman's stain. x 1000 diameters.

FIG. 4. Film from a scraping of throat in Vincent's angina, showing fusiform bacilli and spirochsetes. x 1000 diameters.

FIG. 5. Gonorrhceal pus, showing gonococci (stained red) and staphylococci. Gram's method. x 1000 diameters.

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FIG. 2.

FIG. 3.

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FIG. 4.

FIG. 5.

PLATE II.

FIG. 6. Spirochsete pallida in section of spleen of child ; case of congenital syphilis. Levaditi's stain. x 1000 diameters.

FIG. 7. Tubercle bacillus and other bacteria in sputum ; case of chronic phthisis. Ziehl-Neelsen stain.

FIG. 8. Section of leprous skin, showing numerous clumps of bacilli (stained red) in the cutis. Carbol-fuchsin and methylene-blue. x 80 diameters.

.

FIG. 9. Section of leprous granulation tissue, showing large numbers of bacilli, chiefly contained within cells. Carbol-fuchsin and methylene-blue. x 1000 diameters.

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FIG. 6

FIG. 7.

FIG. 8.

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PLATE III.

FIG.

FIG.

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10. Streptothrix actinomyces, from agar culture. Gram's method.

11. Anthrax bacilli, from 4-days' agar culture, showing spores.

Carbol-fuchsin and methylene-blue. x 1000 diameters.

12. Bacillus diphtherise, from a 12-hours' blood serum culture.

Neisser's cresoidin method. x 1000 diameters.

13. Bacillus diphtherise, from a 5-day s' blood serum culture, show-

ing involution forms. Neisser's cresoidin method.

14. Pseudo-diphtheria bacillus (Hofmann's), from young agar

culture. Neisser's cresoidin method. x 1000 diameters.

FIG. 15. Typhoid bacillus, from a 24-hours' agar culture, showing flagella. Rd. Muir's method. x 1000 diameters.

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PLATE IV.

FIG. 16. Negri bodies in nerve cells in rabies (hippocampus of dog).

Alcoholic eosin and methylene-blue. x 1000 diameters.

FIG. 17. Bacillus pestis, showing involution forms, from a salt-agar

culture. x 1000 diameters.

FIG. 18. Blood film, showing the spirochsete of relapsing fever.

Irishman's stain. x 1000 diameters.

FIG. 19. Cholera spirillum, from a 12-hours' agar culture, showing

flagella. x 1000 diameters.

FIG. 20. Bacillus tetani, showing spores.

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ERRATUM.

The Parasites shown in Plate V, Fig. 22, / represent male elements, those marked g are female, and not the reverse as is indicated by the sex signs attached.