Abstract
An investigation of post-operative pneumonia during 1916 and 1917, a report of which has been made by Dr. Whipple, 1 involved a routine search for pneumococci in the mouths of cases admitted to the surgical service of The Presbyterian Hospital.
The method of procedure was as follows: A specimen of sputum or saliva, whatever the patient could expectorate, was received in a sterile jar and sent to the laboratory. The specimen was injected into a mouse and the type of pneumococcus recovered from the mouse was determined by agglutination reactions, testing a pure culture against pneumococcus serum furnished by courtesy of The Rockefeller Institute. When a patient could not expectorate, the throat was swabbed, a culture made from the swab and pneumococci isolated from the culture. After a few months, only expectorated specimens were used, owing to the small percentage of cultures yielding pneumococci. From February to June, 1916, two hundred and forty-nine swab cultures were examined, from forty-three of which pneumococcus was recovered, a percentage of only 17.2. The incidence of pneumococcus in four hundred and twenty-nine expectorated specimens during the same period was one hundred and seventy-five, a percentage of 40.7. If it had been feasible to inoculate a mouse with the washings from a swab immediately after its leaving the mouth, this method of detecting the presence of pneumococcus in the mouth would have been satisfactory; but in consideration of the technique employed it is highly probable that 17.2 per cent, under-estimates the number of individuals in that group harboring pneumococci. However, in tabulating the results according to type, these individuals have been included.
Two thousand four hundred and seventy-seven specimens have been examined, two thousand two hundred and twenty-eight of them expectorated specimens, two hundred and forty-nine swabs.
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