The Lumleian lectures on some moot point in the pathology and clinical history of pneumonia : delivered before the Royal College of Physicians of London on May 30th and June 4th and 6th, 1912 / by Percy Kidd.

  • Kidd, Percy.
Date:
[1912]
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Licence: In copyright

Credit: The Lumleian lectures on some moot point in the pathology and clinical history of pneumonia : delivered before the Royal College of Physicians of London on May 30th and June 4th and 6th, 1912 / by Percy Kidd. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    near the arterial oslia, where fibrous tissue is most abund- ant. In no case was endocarditis found. In many cases the heart was flabby and dilated. This dilatation could not be ascribed to inflammatory or degenerative myocardial changes, as dilatation was present in cases showing nothing more than circumscribed oedema and dilatation of lym- phatics and small blood-vessels. It was only in cases that survived for several days that pronounced degenera- tions of the myocardium could be recognized. In most cases pericarditis was present, the exudation consisting of fibrinous threads containing lymphocytes and scanty diplococci in their meshes. Islets of small-celled infiltra- tion between the muscular fibres were very common. In some instances the myocardium had undergone softening, and in one case extensive coagulative necrosis resulted! The suprarenal capsules were in almost every case found to be the seat of hyperaemia and haemorrhage. Changes in the lungs were rarely observed, and when present they consisted of microscopical collections of small cells round the capillaries. Subcutaneous injection of pneumococcal cultures was rapidly followed by an extensive inflammatory oedema at the seat of inoculation. Sources of Diplococci. It has been shown that pneumococci can be found in the throats of a large proportion of healthy persons, and the virulence of the organisms has been proved by in- oculation of susceptible animals. The virulence of the diplococci thus obtained can be increased by successive passages through suitable animals like the mouse. By analogy we may conclude that successive passages through human subjects must largely add to the virulence of any given strain of pneumococcus. This may help to explain the pernicious character of the disease in some epidemics of pneumonia. According to Park and Williams [6], a lower percentage of strains of diplococci virulent for rabbits was obtained from the throats of normal per-