N NY \ N a \\ N ‘ \ \\ A EEE Ze SES ee +S ANS Uy NARA RN SS ANN WS SENS WAY WA SAN he BAER se RQ AA \ \\ ASS ANY RANA ANN SY WY RAY ARE WS AS Cee LE Cae Le EES AN Wes AAS ANS QE Ah NY x Rs WAN Log oe, Le SS EL we ap c. New Pork State College of Agriculture At Qornell University Ithaca, N. J. Library Cornell University Library The fundamentals of bacteriology, Cornell University The original of this book is in the Cornell University Library. There are no known copyright restrictions in the United States on the use of the text. http://www.archive.org/details/cu31924003205816 ANTHONY VAN LEEUWENHOEK Who first saw bacteria THE FUNDAMENTALS OF BACTERIOLOGY BY CHARLES BRADFIELD MORREY, B.A., M.D. PROFESSOR OF BACTERIOLOGY AND HEAD OF THE DEPARTMENT IN THE OHIO STATE UNIVERSITY, COLUMBUS, OHIO ILLUSTRATED WITH 165 ENGRAVINGS AND 6 PLATES LEA & FEBIGER PHILADELPHIA AND NEW YORK 1917 lec CopyRIGHT LEA & FEBIGER 1917 TO GRACE HAMILTON MORREY AMERICAN PIANIST PREFACE. AN experience of nearly twenty years in the teaching of Bacteriology has convinced the author that students of this subject need a comprehensive grasp of the entire field and special training in fundamental technic before specializing in any particular line of work. Courses at the University are arranged on this basis. One semester is devoted to General Bacteriology. During the second semester the student has a choice of special work in Pathogenic, Dairy, Soil, Water, or Chemical Bacteriology. A second year may be devoted to advanced work in any of the above lines, to Immunity and Serum Therapy, or to Pathogenic Protozoa. This text-book is intended to cover the first or introductory semester’s work, and requires two class-room periods per week. Each student is compelled to take two laboratory periods of three hours per week along with the class work. The outline of the laboratory work is given at the end of the text. Results attained seem to justify this plan. A text-book is but one of many pedagogical mechanisms and is not intended to be an encyclopedia of the subject. The author makes no claim to originality of content, since the facts presented are well known to every bacteriologist, though the method of presentation is somewhat different from texts in general. During the preparation of this work he has made a thorough review of the literature of Bacteri- ology, covering the standard text-books as well as works of reference and the leading periodicals dealing with the sub- ject. Thus the latest information has been. incorporated. No attempt has been made to give detailed references in a work of this character. vi PREFACE The photomicrographs are original except where otherwise indicated and are all of a magnification of one thousand diameters where no statement to the contrary appears. These photographs were made with a Bausch & Lomb Pro- jection Microscope fitted with a home-made camera box. Direct current arc light was used and exposures were five to ten seconds. Photographs of cultures are also original with a few indicated exceptions. All temperatures are indicated in degrees centigrade. For use of electrotypes or for prints furnished the author is indebted to the following: A. P. Barber Creamery Supply Company, Chicago, IIl.; Bausch & Lomb Optical Company, Rochester, N. Y.; Creamery Package Manufacturing Com- pany, Chicago, Ill.; Davis Milk Machinery Company, N. Chicago, Il.; Mr. C. B. Hoover, Superintendent of Sewage Disposal Plant, Columbus, O.; Mr. C. P. Hoover, Super- intendent of Water Filtration Plant, Columbus, O.; The Hydraulic Press Manufacturing Company, Mt. Gilead, O.; Loew Manufacturing Company, Cleveland, O.; Metric Metal Works, Erie, Pa.; Sprague Canning Machine Company, Chicago, Ill.; U. S. Marine Hospital Service.; Wallace and Tiernan Company, New York City, N. Y. For the preparation of many cultures and slides, for great assistance in the reading of proof and in the preparation of the index, Miss Vera M. McCoy, Instructor in Bacteriology, deserves the author’s thanks. The author trusts that the book will find a place in College and University courses in Bacteriology. C.B. M. CotumBvs, 1917. CONTENTS. Historical Introduction—Spontaneous Generation—Causation of Disease—Putrefaction and Fermentation—Study of Forms— Chronological Table . CHAPTER I. Position of a a agama to Algee—Yeasts—Molds— Protozoa a Par: Ts MORPHOLOGY. CHAPTER II. Cell Structures—Ce]l Wall—Protoplasm—Plasmolysis—Plasmop- tysis—Nucleus—Vacuoles—Capsules—Metachromatic Granules —Flagella—Spores CHAPTER III. Cell Forms—Coccus—Bacillus—Spirillum CHAPTER IV. Cell Groupings CHAPTER, V. Classification-—Migula’s 17 34 39 49 52 56 x CONTENTS CHAPTER XxX. Study of the Physiology of Bacteria—Temperature—Incubators— Thermal Death Point—Oxygen Relationships—Study of Physi- ological Activities—Appearance of Growth on Culture Media CHAPTER XXI. Animal Inoculation—Material for Bacteriological Examination PART IV. GENERAL PATHOGENIC BACTERIOLOGY. CHAPTER XXII. Introduction — Infection — Acute Infection — Chronic Infection —Specific—Non-specific—Koch’s Postulates—Virulence—Sus- ceptibility . CHAPTER XXIII. . Pathogenic Bacteria Outside the Body—As Saprophytes—i. “nat the protoplasm is denser and the spore cap- v-~- (the percentage of water in each is decidedly Fic. 31.—Drumstick spores at the end of the rod. less than in the growing cell) gives the spore the property of much greater resistance to all destructive agencies than the active bacterium has. For example, all actively growing cells are destroyed by boiling in a very few minutes, while 48 CELL STRUCTURES some spores require several hours’ boiling. The same rela- tion holds with regard to drying, the action of chemicals, light, etc. This resistance explains why it happens that food materials boiled and sealed in cans to prevent the entrance of organisms sometimes spoil. The spores have not been killed by the boiling. It explains also in part the persistence of some diseases like anthrax and black leg in pastures for years. From the above description it follows that the spore is to be considered as a condensation of the bacterial protoplasm surrounded by an especially thick cell wall. Its function ts the preservation of the organism under adverse conditions. It corresponds most closely to the encystment of certain protozoa—the ameba for example. Possibly the spore represents a very rudimentary beginning of a reproductive function such as is gradually evolved in the higher thread bacteria, the fission yeasts, the yeasts, the molds, etc. Its characteristics are so markedly different, however, that the function of preservation is certainly the main one. It must not be supposed that spores are formed under adverse conditions only, because bacteria showing vigorous growth frequently form spores rapidly. Special conditions are necessary for their formation just as they are for the growth and other functions of bacteria (Chapters VI and VII). CHAPTER III. CELL FORMS. Tuoues there is apparently a wide variation in the shapes of different bacterial cells, yet these may all be reduced to three typical cell forms. These are: first and simplest, the round or spherical, typified by a ball and called the coccus form, or coccus, plural cocci! (Fig. 32). The coccus may be large, that is, from 1.54 to 2u in diameter. The term macrococcus is sometimes applied to these large cocci. If the coccus is less than 1 in diameter, it is sometimes spoken of as a micrococcus; in fact, this term is very commonly applied to any coccus. When cocci are growing together, many of the cells do not appear as true spheres but are more or less distorted ftom pressure of their neighbors or from failure to grow to full size after recent division. Most cocci divide into hemispheres and then each half grows to full size. A few cocci elongate before division and then appear oval or elliptical. The second cell form is that of a cylinder or rod typi- fied by a section of a lead-pencil. The name bacillus, plural bacilli, is applied to this type (Fig. 33). The bacillus may be short (Fig. 34), 1» or less in length, or long, up to 40u in rare cases. Most bacilli are from 24 to 5y or 6p long. The ends of the rod are usually rounded, occasionally square and very rarely pointed. It is evident that a very short rod with rounded ends approaches a coccus in form and it is not always easy to differentiate in such cases. Most bacilli are straight, but some are slightly curved (Fig. 35). 1 The pronunciation of this word according to English standards is ’ kék-si; the continental pronunciation is k6k-kee; the commonest American seems to be k6Ok-ki. We prefer the latter since it is easier and more natural and should like to see it adopted. (Author.) 4 50 CELL FORMS The third cell form is the spiral, typified by a section of a cork-screw and named spirillum, plural spirilla (Fig. 36). A very short spiral consisting of only a portion of a turn is some- times called vibrio (Fig. 37). Vibrios when seen under the Fig. 32.—Cocci. Fic. 33.—Bacilli. microscope look like short curved rods. The distinction between the two can be made only by examining the organ- ism alive and moving in a liquid. The vibrio shows a char- acterisiie sprrai cwiseing motion. Very long flexible spirals are Fic. 34.—Short bacilli. Fic. 35.—Curved bacilli. Only the one in the center of the field is in focus. The others curve out of focus. usually named spirochetes (Fig. 38). The spirochetes are motile but flagella have not been shown to be present. Besides the three typical cell forms bacteria frequently show very great irregularities in shape. They may be CELL FORMS 51 pointed, bulged, club-shaped or even slightly branched. These peculiar and bizarre forms practically always occur when some of the necessary conditions for normal growth, © € Fig. 36.—Spirilla. Fic. 37.—Vibrio forms of spirilla. Compare with Fig. 35. discussed in Chapters VI and VII, are not fulfilled. They are best regarded as involution or degeneration forms for this reason (Fig. 39). In a very few cases it is not possible to obtain the organism without these forms (the diphtheria Fic. 38.—Spirochetes. Fic. 39.—Involution forms. The organisms are taperingand branched at one end. group). It is probable that these cell forms are normal in such cases, or else conditions suitable for the normal growth have not been’ obtained. CHAPTER IV. CELL GROUPINGS. Ir has been stated that bacteria reproduce by trans- verse division, that is, division across the long axis. Fol- ' lowing repeated divisions the new cells may or may not remain attached. In the latter case the bacteria occur as separate isolated individuals. In the former, arrangements characteristic of the particular organism almost invariably result. These arrangements are best described as cell groupings, or growth forms. Fic. 40.—Streptospirillum grouping. Fic. 41.—Diplobacillus grouping. In the case of spiral forms it is obvious that there is only one possible grouping, that is, in chains of two or more individuals adherent end to end. A chain of two spirilla might be called a diplospirillum (dirdés = double); of _three or more, a streptospirillum (orpertés = necklace, chain) (Fig. 40). These terms are rarely used, since spirilla do not ordinarily remain attached. Likewise the bacillus can grow only in chains of two or moré, and the terms diplo- bacillus (Fig. 41), bacilli in groups of two, and streptobacillus (Fig. 42), bacilli in chains are frequently used. Still the terms thread, filament, or chain are more common for streptobacillus. CELL GROUPINGS 53 Since the coccus is spherical, transverse division may occur in any direction, though in three planes only at right angles to each other. Division might occur in one plane only as in spirilla and bacilli, or in two planes only or in all three planes. Fig. 42.—Streptobacillus grouping. Fig. 43.—Typical diplococcus grouping. Note that the individual cocci are flattened on the appos- ing sides. As a matter of fact these three methods of ‘division are found among the cocci, but only one method for each par- ticular kind of coccus. As a result there may be a variety : ----ags among the cocci. When division occurs in Fic. 44.—Long streptococcus . Fie. 45.—Short streptococcus grouping. grouping. one plane only, the possible groupings are the same as among the spirilla or bacilli. The eocci may occur in groups of two— diplococcus grouping (Fig. 43), or in chains—streptococcus grouping (Figs. 44 and 45). When the grouping is in diplococci, 54 CELL GROUPINGS the individual cocci most commonly appear as hemispheres with the plane surfaces apposed (Iig.43). Sometimes they ap- pear as spheres, and occasionally are even somewhat elongated. The individuals in a streptococcus grouping are most com- monly elongated, either in the same direction as the length of the chain, or at right angles to it. The latter appearance is probably due to failure to enlarge completely after division. Streptococci frequently appear as chains of diplococci, that is, the pair resulting from the division of a single coccus remain a little closer to each other than to neighboring cells, as a close inspection of Fig. 44 will show. If division occurs in two planes only, there may result the above groupings and several others in addition. The four cocci which result from a single division may remain together, giving the tetracoccus or tetrad grouping. Very rarely all the cocci divide evenly and the result is a regular rectangular flat mass of cells, the total number of which is a multiple of four. The term merismopedia (from a genus of algee which grows the same way) is applied to such a grouping. If the cells within a group after a few divisions do not reproduce so rapidly (lack of food), as usually happens, the number of cells becomes uneven or at least not necessarily a multiple of four and the resultant flat mass has an irregular, uneven outline. This grouping is termed staphylococcus (otadvdos = a bunch of grapes) (Fig. 46). It is the most common group- ing among the cocci. When division occurs in all three planes, there is in addi- tion to all the groupings possible to one- and two-plane divi- sion a third grouping in which the cells are in solid packets, multeples of erght. The name sarcina is applied to this growth form (Fig. 47). The individual cells in a sarcina packet never show the typical coccus form so long as they remain together, but are always flattened on two or more sides. The above descriptions indicate how the method of divi- sion may be determined. If in examining a preparation the sarcina grouping appears, that shows three-plane division. If there are no sarcina, but tetrads or staphylococci (rarely merismopedia), then the division is in two planes. If none of the foregoing is observed but only diplo- or strepto- CELL GROUPINGS 55 cocci, these indicate one-plane division only. Cocci show their characteristic groupings only when grown in a liquid medium, and such should always be used before deciding on the plane of division. Fic. 46.—Staphylococcus group- Fig. 47.—Sarcina grouping. ing. The large flat masses are staphylococcus grouping. Diplo- coccus grouping, tetrads and short streptococci are also evident. ms the above description shows, these terms which are ~ ucieetives describing the cell grouping, are quite 'y wsed as nouns. Thus the terms a diplococcus, a a, & streptococcus, etc., are common, meaning a bac- terium of the cell form and cell grouping indicated. Crit Form. CELL GROUPING. diplococcus—in 2’s. streptococcus—in chains. tetracoccus, tetrads—in 4’s. staphylococcus—irregular flat. masses. sarcina—regular, solid~ packets, multiples coccus—round or spherical. of 8. bacillus—rod-shaped or diplobacillus—in 2’s. cylindrical. streptobacillus—in chains. diplospirillum—in 2’s, little used. spirillum—spiral-shaped. streptospirillum—in chains, little used. CHAPTER V. CLASSIFICATION. THE arrangement of living organisms in groups accord- ing to their resemblances and the adoption of fixed names is of the greatest advantage in their scientific study. For animal forms and for the higher plants this classification is gradually becoming fixed through the International Congress of Zodlogists and of Botanists respectively. Unfortunately, the naming of the bacteria has not as yet been taken up by the latter body, though announced as one of the subjects for the Congress of 1916 (postponed on account of the war). Hence there is at present no system which can be regarded as either fixed or official. Since Miiller’s first classification of “animalcules” in 1786 numerous attempts have been made to solve the problem. Only those beginning with Ferdinand Cohn (1872-75) are of any real value. As long as bacteria are regarded as plants it appears that the logical method is to follow the well-established botanical principles in any system for nam- ing them. Botanists depend on morphological features almost entirely in making their distinctions. The preceding chapters have shown that the minute plants which are discussed have very few such features. They are, to recapitulate, cell wall, protoplasm, vacuoles, metachromatic granules, capsules, flagella, spores, cell forms, and cell group- ings. Most bacteria show not more than three or four of these features, so that it is impossible by the aid of morphol- ogy alone to distinguish from each other the large number of different kinds which certainly exist. In the various systems which are conceded to be the best these charac- teristics do serve to classify them down to genera, leaving ‘the “species” to be determined from their physiological CLASSIFICATION 57 activities. One of these systems has been adopted by the laboratory section of the American Public Health Associa- tion and by the Society of American Bacteriologists and is Fic. 48.—Illustrates the genus Fic. 49.—Illustrates the genus Streptococcus. Typical chains, no Micrococcus. Diplococcus, tetrads, staphylococcus grouping, no sarcina short chains and staphylococcus; grouping, no flagella. no sarcina, no flagella. practically the standard in this country. It is that of the German Bacteriologist Migula and is the only one which will be considered here and used throughout this book. Fic. 50.—Illustrates the genus Fie. 51.—Illustrates the genus Sarcina. Sarcina grouping, no Bacillus. A bacillus with peritri- flagella. chic flagella. (Student prepara- tion.) Personally, the author would prefer some slight modifications, but as he is not a botanist, will not presume to make them. Since practically the entire discussion in this book is con- 58 CLASSIFICATION Fie. 52.—Illustrates the genus Fic. 53.—Illustrates the genus Pseudomonas. A bacillus with flag- Microspira. It is (though the ella at the end only. photograph does not prove it) a short spiral with one flagellum at the end. Fic. 54.—Illustrates the genus Fic. 55.—Illustrates the genus Spirillum. Spiral bacteria with Spirocheta. more than three, in this case four, flagella at the end. Fig. 56.—TIllustrates the genus Fig. 57.—Illustrates the genus Chlamydothrix. Fine threads with a Crenothrix. The thickness of the delicate sheath. cell walls is due to deposits of iron hydroxide. (After Lafar.) CLASSIFICATION 59 cerned with the first three families, the generic character- istics in these only will be given. The full classification as Fic. 58.—Illustrates the genus Beggiatoa. The filament A is so full of sulphur granules that the individual cells are not visible. B has fewer sulphur granules. In C the granules are nearly absent and the separate cells of the filament are seen. (After Winogradsky, from Lafar.) well as a thorough discussion of, this subject is given in Lafar’s Handbuch, whence the following is adopted: ORDER I. EUBACTERIA. out nuclei, free from sulphur granules and from Suuvemupee wpavin (p. 100); colorless, or slightly colored. 1. Family: Coccacra (Zopf) Migula, all cocci. Genus 1. Streptococcus Billroth: division in one plane only (Fig. 48). Non-flagellated, “ 2. Micrococcus (Hallier) Cohn:: division in two non-motile planes only (Fig. 49). «3. Sarcina Goodsir: division in three planes only ~ (Fig. 50). Flagellated, “ 4, Planococcus Migula: division in two planes only. motile “ 5. Planosarcina Migula: division in three planes only. 2. Family: Bacreriace# Migula, all bacilli. Genus 1. Bactertum (Ehrenberg) Migula: no flagella; non-motile. “ 2. Bacillus (Cohn) Migula: flagella peritrichic (Fig. 51). 3. Pseudomonas Migula: flagella at the end: mono- trichic, lophotrichic, amphitrichic (Fig. 52). « 60 CLASSIFICATION 3. Family: Sprrittacra# Migula, all spirilla. Genus 1. Spirosoma Migula: non-flagellated; non-motile. “2. Microspira (Schréter) Migula: flagella one to Cells stiff three at the end (Fig. 53). “3. Spirillum (Ehrenberg) Migula: flagella more fas three at the end (Fig. 54). 4. Spirocheta Ehrenberg: motile; no flagella (Fig. 55). “ Cell flexible 4. Family: CHLAMYDOBACTERIACES. Cells cylindrical in long threads, and surrounded by a sheath. Reproduction also by gonidia formed from an entire cell. Genus 1. Chlamydothrix Migula (Fig. 56). “2. Crenothriz Cohn (Fig. 57). “3. Pragmidiothriz Engler. “ 4. Spherotilus (including Cladothrix). ORDER II. THIOBACTERIA: SULPHUR BACTERIA. Cells without a nucleus, but containing sulphur granules, may be colorless or contain bacteriopurpurin and be colored reddish or violet. 1. Family Breeratoaces. Genus 1. Thiothrix Winogradsky. “2. Beggiatoa Trevisan. ‘Of interest since it is with- out a sheath, is motile, but without flagella (Fig. 58). 2. Family RHODOBACTERIACES. This has five subfamilies and twelve genera, most of which are due to the Russian bacteriologist Winogradsky who did more work than anyone else with the sulphur bacteria. PART II. PHYSIOLOGY. CHAPTER VI. GENERAL CONDITIONS FOR GROWTH. OCCURRENCE. BacrTeria are probably the most widely’ distributed of living organisms. They are found practically everywhere on the surface of the earth. Likewise in all surface waters, in streams, lakes and the sea. They occur in the air imme- diately above the surface, since they are carried up mechan- ically by air currents. They cannot fly of themselves. There is no reason to believe that any increase in numbers occurs to an appreciable extent in the air. The upper air, for example, on high mountains, is nearly free from them. So also is the air over midocean, and in high latitudes. As a rule, the greater the amount of dust in the air, the more ~ numerous are the bacteria. Hence they are found more abundantly in the air in cities and towns than in the open country. The soil is especially rich in numbers in the upper few feet, but they diminish rapidly below and almost disap- pear at depths of about six feet unless the soil is very porous and open, when they may be carried farther down. Hence the waters from deep wells and springs are usually devoid of these organisms. In the sea they occur at all levels and have been found in bottom ooze dredged from depths of several miles. It is perhaps needless to add that they are found on the bodies and in the alimentary tract of human 62 GENERAL CONDITIONS FOR GROWTH ' beings and animals; on clothing, utensils; in dwellings, stables, outhouses, etc. From one-fourth to one-half of the dry weight of the feces of animals and men is due to the bacteria present. The urine is practically free from them in health. While bacteria are thus found nearly everywhere, it is an entirely mistaken idea to suppose that all are injurious to man. Asa matter of fact, those which are dangerous are relatively few and are for the most part found only in close association with man. Most bacteria are harmless and the vast majority are beneficial or even essential to man’s existence on the earth. These facts must be constantly borne in mind, and it is hoped that the pages which follow will make them clear. In order that any organism may thrive there are a number of general environmental conditions which must be fulfilled. These conditions vary more or less for each kind of organ- ism. Bacteria are no exception to this general rule. These conditions may be conveniently considered under the gen- eral heads of movtsture; temperature; light; oxygen supply; osmotic pressure; action of electricity; of Réntgen and radium rays; pressure; mechanical vibration; and chemical environ- ment, including the reaction of the medium, the effect of injurious chemicals, and especially the food requirements of bacteria. For each of these conditions there is a maximum, meaning the greatest amount of the given condition which * the organism can withstand, a minimum, or the least amount, and an optimum or that amount which is most favorable for development. Further, there might be distinguished a maxi- mum for mere existence and a lower maximum for develop- ment; also a minimum for mere existence and a higher mini- mum for development. These maxima, minima, and optima for bacteria have been determined with exactness for only a very few of the general conditions and for comparatively few kinds. MOISTURE 63 MOISTURE. The maximum moisture is absolutely pure water, and no ‘organism can thrive in this alone owing to the factor of too low osmotic pressure and to the further factor of absence of food material. There are many bacteria which thrive in water containing only traces of mineral salts and a large class whose natural habitat is surface water. These “water bacteria’”’ are of great benefit in the purification of streams. They are as a class harmless to men and animals. Some of the disease-producing bacteria like Bacillus typhosus (of typhoid fever) and Microspira comma (of Asiatic cholera) were undoubtedly originally water bacteria, and it is rather striking that in these diseases conditions are induced in the intestine (diarrheas) which simulate the original watery environment. The minimum moisture condition is abso- lute dryness, and no organism can even exist, not to say develop, in such a condition since water is an essential con- stituent of living matter.. Some bacteria and especially most spores may live when dried in the air or by artificial means for months and even years, while some are destroyed in a few hours or days when dried (typhoid, cholera, etc.). The optimum amount of moisture has not been determined with any great accuracy and certainly a rather wide range in percentage of water is permissable with many, though a liquid medium is usually most favorable for artificial growth. The “water bacteria” have been mentioned. In the soil a water content of 5 to 15 per cent. seems to be most suitable for many of the organisms which aid in plant growth. In animals and man the organisms infecting the intestinal tract prefer a high percentage of moisture as a rule, especially those causing disease here. Those found on the surface of the body (pus cocci) need a less amount of water, while those invading the tissues (tuberculosis, black- leg, etc.) seem to be intermediate in this respect. In arti- ficial culture media a water content:of less than 30 per cent. inhibits the growth of most bacteria. As a general rule those bacteria which require the largest, percentage of water are most susceptible to its loss and are 64 GENERAL CONDITIONS OF GROWTH most readily killed by drying. The typhoid and cholera organisms die in a few hours when dried, while pus cocci and tubercle bacilli live much longer. TEMPERATURE. The temperature conditions for bacterial existence and growth have been determined more accurately than any of the other general conditions. The maximum for existence must be placed at or near 100° since it is known that all bacteria including spores may be killed by boiling in time. Nevertheless, certain forms have been reported as thriving in hot springs where the water temperature was 93°. This is the highest known temperature for development. The minimum for existence lies at or near the absolute zero (—273°) since certain organisms have been subjected to the temperature produced by the sudden evaporation of liquid hydrogen (— 256° to— 265°) and have remained alive. Whether they could withstand such temperatures indefinitely is not known. The minimum for development is near the freez- ing-point of water, since reproduction by division has been observed in the water from melting sea-ice at a temperature of —1.5°. Thus bacteria as a class have a range for existence of about 373° (—273° to +100°) and for development of 94.5° (—1.5° to +93°) certainly much wider ranges than any other group of organisms.! The optimum temperature for development varies within rather wide limits for different organisms. In general it may be stated that the optimum temperature is approxi- mately that of the natural habitat of the organism, though there are exceptions. The optimum of the “hot spring” bacteria just mentioned is apparently that of the springs (93° in this case). Many ‘soil organisms are known whose optimum is near 70° (a temperature rarely, if ever, attained in the soil), but only when grown in air or oxygen; 1 With the possible exception of blue green algze which have been found with bacteria in the above-mentioned hot springs. Seeds of many plants have been subjected to as low temperatures as those above-mentioned with- out apparent injury. LIGHT 65 but is very much lower when grown in the absence of oxygen. Many other soil organisms exhibit very little difference in rate or amount of growth when grown at temperatures which may vary as much as 10° or 15°, apparently an adaptation to their normal environment. The disease-pro- ducing organisms show much narrower limits for growth, especially those which are difficult to cultivate outside the body. For example, the bacterium of tuberculosis in man scarcely develops beyond the limits of 2° or 3° from the normal body temperature of man (37°), while the bacterium of tuberculosis in birds grows best at 41° to 45°, the normal for birds, and the bacterium of so-called tuberculosis of cold- blooded animals at 14° to 18°. Those bacteria whose optimum temperature is above 40° are sometimes spoken of as the “thermophil” bacteria. The fixing of the “thermal death-point,” that is, the tem- perature at which bacteria are killed is a matter of great practical importance in many ways and numerous deter- minations of this have been made with a great many organ- isms and by different observers. The factors which enter into such determinations are so many and so varied that unless all the conditions of the experiment are given, the mere statements are worthless. It may be stated that all young, actively growing (non-spore-containing) disease-pro- ducing bacteria, when exposed in watery liquids and wm small quantities are killed at a temperature of 60° within half an hour. It is evident that this fact has very little practical application, since the conditions stated are rarely, if ever, fulfilled except in laboratory experiments. (See Sterilization and Pasteurization, Chapter XIII.) LIGHT. Speaking generally, it can be said that light is destructive to bacteria. Many growing forms are killed in a few hours when properly exposed to direct sunlight and die out in several days in the diffuse daylight of a well-lighted room. Even spores are destroyed in a similar manner, though the exposure must be considerably longer. Certain bacteria 5 66 GENERAL CONDITIONS FOR GROWTH which produce colors may grow in the light, since the pig- ments protect them. Some few kinds, like the sulphur bac- teria, which contain a purplish-red pigment that serves them to break up H.S, need light for their growth. Since disease-producing bacteria are all injuriously affected by light, the advantage of well-lighted habitations both for men and animals is obvious. OXYGEN SUPPLY. Oxygen is one of the constituents of protoplasm and is therefore necessary for all organisms. This does not mean that all organisms must obtain their supply from free oxygen, however, as animals and plants generally do. This fact is well illustrated by the differences among bacteria in this respect. Some bacteria require free oxygen for. their growth and are therefore called aérobic bacteria or aérobes (sometimes strict aérobes, though the adjective is unnecessary). Others cannot grow in the presence of free oxygen and are therefore named anaérobic bacteria or anaérobes (strict is unnecessary). There are still other kinds which may grow either in the presence of free oxygen or in its absence, hence the term facultative anaérobes (usually) is applied to them. The dis- tinction between facultative aérobe and facultative anaérobe might be made. The former means those which grow best in the absence of free oxygen, though capable of growing in its presence, while the latter term means those which grow best in the presence of free oxygen, but are capable of grow- ing in its absence. The amount of oxygen in the atmos- phere in which an organism grows may be conveniently expresssed in terms of the oxygen pressure, 7. ¢., in milli- meters of mercury. It is evident that the maximum, mini- mum and optimum oxygen pressures for anaérobic bacteria are the same, namely, 0 mm. Hg. This is true only for nat- ural conditions, since a number of anaérobic organisms have been gradually accustomed to increasing amounts of O, so that by this process of training they finally grew in ordinary air, that is, at an oxygen pressure of about 150 mm. Hg. (Normal air pressure is 760 mm. Hg. and oxygen makes up OXYGEN SUPPLY 67 one-fifth of the air.) The minimum O pressure for faculta- tive anaérobes is also 0 mm. Hg. Some experiments have been made to determine the limits for aérobes, but on a few organisms only, so that no general conclusions can be drawn from them. To illustrate: Bacillus subtilis (a com- mon “hay bacillus’) will grow at 10 mm. Hg. pressure but not at 5 mm. Hg. It will also grow in compressed oxygen at a pressure of three atmospheres (2280 mm. Hg.), but not at four atmospheres (3040 mm. Hg.), though it is not destroyed. Parodko has determined the oxygen limits for five com- mon organisms as follows: Minimum. Maximum. Vol. Mm. In atmospheres. Mm. Hg. per cent. Hg. Bacillus fluorescens 1.94 to 2.51 1474 to 1908 0.00016 =0.0012 Sarcina lutea . » 2.51 to3.18 1908 to 2417 0.00015 =0.0011 Bacillus vulgaris . 38.63 to 4.35 2749 to 3306 0 0 Bacillus coli - 4.09 to 4.84 3108 to 3478 0 0 Bacillus prodigiosus . 5.45 to 6.32 3152 to 4800 0 0 These few instances do not disclose any general principles which may be applied either for the growth or for the dis- tinction of aérobes or facultative anaérobes. It has been shown that compressed oxygen will kill some bacteria but this method of destroying them has little or : no practical value. Oxygen in the form of ozone, Os, is rapidly destructive to bacteria, and this fact is applied prac- tically in the purification of water supplies for certain cities where the ozone is generated by electricity obtained cheaply from water power. The same is true of oxygen in the “nascent state” as illustrated by the use of hypochlorites for the same purpose. It was stated (p. 64) that certain thermophil bacteria in the soil have an optimum temperature for growth in the air which is much higher than is ever reached in their natural habitat, and that they grow at a moderate temperature under anaérobic conditions. It has been shown that if these organ- isms are grown with aérobes or facultative anaérobes they thrive at ordinary room temperature. These latter organ- 68 GENERAL CONDITIONS FOR GROWTH isms by using up the oxygen apparently keep the tension low, and this explains how such organisms grow in the soil.? OSMOTIC PRESSURE. Like all living cells bacteria are very susceptible to changes in the density of the surrounding medium. If placed in a medium less concentrated than their own protoplasm water is absorbed and they “swell up;” while if placed in a denser medium, water is given off and they shrink (plasmoptysis or plasmolysis). Should these differences be marked or the transition be sudden, the cell walls may even burst and the organisms be destroyed. If the differences are not too great or if the transition is made gradually, the organ- isms may not be destroyed, but will either cease to grow and slowly die out, or will show very much retarded growth, or will produce abnormal cell forms. This is illustrated in the laboratory in attempting to grow bacteria on food material which has dried out. A practical application of osmotic effects is in the use of a high percentage of sugar in preserv- ing fruits, etc., and in the salting of meats. Neither the cane-sugar nor the common salt themselves injure the bac- teria chemically, but by the high concentration prevent their development. ELECTRICITY. Careful experimenters have shown that the electric cur- rent, either direct or alternating, has. no direct destructive effect on bacteria. In a liquid medium the organisms may be attracted to or repelled from one or the other pole or may arrange themselves in definite ways between the poles (galvanotaxis), but are not injured. However, electricity through the secondary effects produced, may be used to destroy bacteria. If the passage of the electric current ancreases the temperature of the medium sufficiently, the bac- teria will be killed, or if ¢njurious chemical substances are 1Tt is popularly supposed that in canning fruit, vegetables, meats, etc., all the air must be removed, since the organisms which cause ‘‘spoiling”’ cannot grow in a vacuum. The existence of anaérobic and facultative anaérobic bacteria shows the fallacy of such beliefs. MECHANICAL VIBRATION 69 formed (ozone, chlorine, acids, bases,’ etc.), the same result will follow (see Ozone, pp. 67, 138 and 145). RADIATIONS. _ Réntgen or x-rays and radium emanations when prop- erly applied to bacteria will destroy them. The practical use of these agents for the direct destruction of bacteria in diseases of man or animals is restricted to those cases where they may be applied directly to the diseased area, since they are just as injurious to the animal cell as they are to the bacteria, and even more so. Their skilful use as stimuli to the body cells to enable them to resist and overcome bacteria and other injurious organisms or cell growths is an entirely different function and will not be considered here. PRESSURE. Hydrostatic pressure up to about 10,000 pounds per square inch is without appreciable effect on bacteria as has been shown by several experimenters and also by finding living bacteria in the ooze dredged from thé bottom of the ocean at depths of several miles. Préssures from 10,000 to 100,000 pounds show variable effects. Some bacteria are readily killed and others, even non-spore formers, are only slightly affected. The time factor is important in this connection. The presence of acids, even COs, or organic acids, results in the destruction of most non-spore formers. MECHANICAL VIBRATION. Vibrations transmitted to bacteria in a liquid may be injurious to them under certain circumstances. Some of the larger forms like Bacillus subtis may be completely destroyed by shaking in a rapidly moving shaking machine in a few hours. Bacteria in liquids placed on portions of machinery where only a slight trembling is felt have been found to be killed after several days. Reinke has shown that the passing of strong sound waves through bacterial growths markedly inhibits their development. CHAPTER VII. CHEMICAL ENVIRONMENT. REACTION OF MEDIUM. Most bacteria are very susceptible to changes in the degree of acidity or alkalinity of the medium in which they grow. Some kinds prefer a slightly acid reaction, some a slightly alkaline, and some a neutral (with reference to litmus as indicator). The organism which is the commonest cause of the souring of milk thrives so well in the acid medium it produces that it crowds out practically all other kinds, though its own growth is eventually stopped by too much acid. Acid soils are usually low in numbers of bac- teria and as a consequence produce poor crops. The disease- producing bacteria as a class grow best in a medium which is slightly alkaline. Accurate determination, of limits have been made on but few organisms. The reaction is a most important factor in growing bacteria on artificial media (see Making of Media, Chapter XVI). INJURIOUS CHEMICAL SUBSTANCES. (SEE DISINFECTION AND DISINFECTANTS, Chapter XIII.) CHEMICAL COMPOSITION. The chemical composition is subject to wide variation chiefly for two reasons: First, the cell wall in most instances seems to exert only a slight selective action in the absorption of mineral salts so that their concentration within the cell is very nearly that of the surrounding medium. Second, the chief organic constituents vary remarkably with the kind and amount of food material available—a rich protein CHEMICAL COMPOSITION 71 pabulum increases the protein, a plentiful supply of carbo- hydrates or of fat results in the storing of more fat, especially, and vice versa. These facts must be borne in mind in con- sidering the chemistry of bacteria. Of the chemical elements known, only the following seem to be essential in the structure of bacteria: carbon, vhydrogen, oxygen, nitrogen, sulphur, phosphorus, chlorine, potassium, calcium, magnesium, iron, manganese. Other elements, as sodium, iodine, silicon, aluminum, lithium, copper, etc., have been reported by different analysts, but none of them can be regarded as essential, except possibly in isolated instances. These elements exist in the bacterial cell in a great variety of combinations of which the most abundant is water. The amount of water varies in different species from 75 to 90 per cent. of the total weight in growing cells, and is less in spores. The amount of ash has been shown by different observers to vary from less than 2 per cent. to as much as 30 per cent. of the dry weight. The following table com- piled from various sources will give an idea of the relative abundance of the different elements in the ash: Sas SOs 7.64 per cent. (much more in sulphur bacteria) Pas P2Os 18.14 * to 73.94 per cent. cl Sy ee Ge od 2.29 e K as K:0 11.1 es to 25.59 fe Ca as CaO 12.64 ss to 14.0 S Mgas MgO. . 0.77 es to 11.55 ss Fe as Fe:Os 4 1.0 ss to 8.15 s (iron bacteria) Mn. ‘ traces As to the form in which the last six elements in the table exist in the cell, little is known. The sulphur and phos- phorus are essential constituents of various proteins. The high percentage of phosphorus points to nuclein compounds as its probable source. The carbon and nitrogen, together with most of the hydrogen and oxygen not united as water, make up the ‘great variety of organic compounds which compose the main substances in the bacterial cell. It has already been stated that the essential structures in the bacterial cell are cell wall and protoplasm, including 72 CHEMICAL ENVIRONMENT the nuclein. These differ markedly in chemical composition. It is well known that the cell walls of green plants consist largely of cellulose and closely related substances.! True cellulose has been recognized in but very few bacteria. (Sarcina ventriculi, Migula; Bacterium tuberculosis, Ham- merschlag, Dreyfuss, Nishimura; Bacillus subtilis, Drey- fuss; Bacterium xylinum, Brown; Bacterium acidi oxalic, Banning and a few others.) It is certainly not an important constituent of the cell wall in many. On the other hand, hemicellulose and gum-like substances have been identified in numerous organisms of this class as important constit- uents of the cell wall and of the capsule which is probably an outgrowth from the latter. Practically always associated with these substances are compounds containing nitrogen. One of these has been certainly identified as chitin or a closely similar substance. Chitin is the nitrogenous sub- stance which enters largely into the composition of the hard part of insects, spiders and crustaceans. It is an interesting fact to find this substance characteristic of these animals in bacteria, as well as other fungi. Though it is extremely difficult to separate the cell wall of bacteria from the cell contents, in the light of our present knowledge it can be stated that the cell walls are composed of a carbohydrate body closely related to cellulose, though not true cellulose, probably in close combination with chitin. Of the organic constituents of the cell contents the most abundant are various proteins which ordinarily make up about one-half of the dry weight of the entire cell. The “Mycoproteid” of Nencki, 1879, and other earlier workers is deserving of little more than historical interest, since these substances were certainly very impure and probably con- sisted of mixtures of several “proteins” in the more recent sense. 1“By cellulose is understood a carbohydrate of the general formula (CeHi00s) not soluble in water, alcohol, ether, or dilute acids but soluble in an ammoniacal solution of copper oxide. It gives with iodine and sul- phuric acid a blue color and with iodine zine chloride a violet and yields dextrose on hydrolysis.’—H. Fischer. CHEMICAL COMPOSITION 73 From later studies it seems probable that substances resembling the albumin of higher forms do not occur in bacteria, at least in appreciable quantities. Globulin has been reported by Hellmich in an undetermined bacterium, but is certainly not commonly found. The larger portion of the protein is of a comparatively simple type, in fact, consists of protamins most of which are in combination with nucleic acid as nucleoprotamins. Practically all recent workers find a high percentage of nuclein, both actually isolated and as indicated by the amounts of purin bases— xanthin, guanin, adenin—obtained, as well as by the abun- dance of phosphorus in the ash, already mentioned. Some of these nucleins have been shown to have poisonous properties. ; Closely related to but not identical with the proteins are the enzymes and toxins which are formed in the cell and exist there as endo-enzymes or endotoxins respectively. These substances will be discussed later under the heading “Physiological Activities of Bacteria” (Chapter XII). Carbohydrates are not commonly present in the cell con- tents, though glycogen has been observed in a few and a substance staining blue with iodine in one or two others. This latter substance was at first considered to be starch “oranulose,”’ but is probably more closely related to glycogen. Fats seem to be very generally present. The commoner fats—tri-olein, tri-palmitin, tri-stearin have been found by many analysts. The “acid-fast bacteria” are particularly rich in fatty substances, especially the higher wax-like fats. Lecithins (phosphorized fats) and cholesterins (not fats but alcohols) have been repeatedly observed and probably occur in all bacteria as products of katabolism. Organic acids and esters occur as cell constituents but will be discussed in connection with their more character- istic oceurrences as products of bacterial activity, as will also pigments which may likewise be intracellular in some instances. The following analysis of tubercle bacilli, from de Schweinitz and Dorset, while not intended as typical for all bacteria, still illustrates the high percentage of protein 74 CHEMICAL ENVIRONMENT compounds which undoubtedly occurs in most, as well as showing the large amount of fatty substance in a typical “acid-fast” organism: per cent. tuberculinic acid 8.5 24.5 * In the dried } 23.0 st organisms 8.3 26.5 9.2 nucleoprotamin neucleoprotein ; 55.8 per cent. protein. proteinoid fat and wax ash CHAPTER VIII. CHEMICAL ENVIRONMENT (ContinveEp). GENERAL FOOD RELATIONSHIPS. METABOLISM. Tue foregoing brief review of the chemical composition of the bacterial cell illustrates the variety of compounds which necessarily occurs, but affords no definite clue as to the source of the elements which enter into these compounds. These elements come from the material which the organism uses as food. Under this term are included elements or compounds which serve as building material, either for new cell substance or to repair waste, or as sources of energy. An organism which is capable of making use of an element in the free state is said to be prototrophic for that particular element. Thus aérobes and facultative anaérobes are proto- trophic for O. The “root-tubercle bacteria” of leguminous and other plants and certain free living soil organisms are prototrophic for N.1 On the other hand, if the element must be secured from compounds, then the organism is metatrophic in respect to the element in question. Should the compound be inorganic, the term autotrophic is applied to the organism, and hetero- trophic if the compound is organic. It is very probable that anaérobes, exclusive of a few nitrogen absorbers, are meta- trophic for all the elements they utilize. With the excep- tion of the anaérobes it seems that all bacteria are mizo- trophic, that is, prototrophic for one or two elements and auto- or heterotrophic for the others.? 1 The sulphur bacteria are partially prototrophic for 8; probably the iron bacteria also for Fe. Some few soil bacteria have been shown to be capable of utilizing free H, and it seems certain that the bacteria associated with the spontaneous heating of coal may oxidize free C. So far as known no elements other than these six are directly available to bacteria. 2 Only a few kinds of bacteria so far as known are proto-autotrophic. The nitrous and nitric organisms of Winogradsky, which are so essential in the soil, and which might have been the first of all organisms so far as their food is concerned, and some of the sulphur bacteria are examples. 76 CHEMICAL ENVIRONMENT Those bacteria whose food consists of dead material are spoken of as saprophytes, while those whose natural habitat, without reference to their food, is in or on other living organisms are called parasites. The host is the organism in or on which the parasite lives. Parasites may be of several kinds. Those which neither do injury nor are of benefit to the host are called non-pathogenic parasites or commensals; many of the bacteria in the intestines of man and other ani- mals are of this class. Those which do injury to the host are called pathogenic or disease-producing, as the organisms causing the transmissible diseases of animals and plants. Finally, we have those parasites which are of benefit to and receive benefit from the host. These are called symbionts or symbiotic parasites and the mutual relationship symbiosis. Certain of the intestinal bacteria in man and especially in herbivorous animals are undoubted symbionts, as are also the “root-tubercle bacteria’’ already mentioned. It is also evident that all parasites that may be cultivated outside the body are for the time saprophytic, hence the terms strict parasites and facultative parasites, which should require no further explanation. The changes which the above-mentioned types of food material undergo in the various anabolic and katabolic pro- cesses within the cell are as yet but very slightly known. Nevertheless there are a number of reactions brought about by bacteria acting on various food materials, partly within but largely without the cell which are usually described as “physiological activities” or ‘biochemical reactions.’’ Some of these changes are to be ascribed to the utilization of certain of the elements and compounds in these materials as tissue builders, some as energy-yielding reactions and still others as giving rise to substances that are of direct benefit to the organism concerned in its competition with other organisms. Though all of the twelve elements already mentioned are 1 The term pathogenic is also applied to certain non-parasitic saprophytic bacteria whose products cause disease conditions, as one of the organisms causing a type of meat-poisoning in man (Bacillus botulinus) and certain fungi found on spoiled fodder or grain. GENERAL FOOD RELATIONSHIPS—METABOLISM 77 essential for the growth of every bacterium, two of them are of especial importance for the reason that most of the “physiological activities” to be described in the next chap- ters are centered around their acquisition and utilization. These elements are carbon and nitrogen. Some few of the special activities of certain groups have to do with one or the other of the remaining nine, as will be shown later. But generally speaking, when a bactertwm under natural con- ditions secures an adequate supply of carbon and nitrogen, the other elements are readily available in sufficient amount. Carbon is necessary not only because it is an essential constituent of protoplasm but because its oxidation is the chief source of the energy necessary for the internal life of the cell, though nitrogen and sulphur replace it in this function with a few forms. This latter use of carbon con- stitutes what may be called its respiratory function. Bac- teria like other organisms in their respiration utilize oxygen and give off carbon dioxide. The amount of the latter given off from the cell in this way is very small as compared with that which is frequently produced as an accompaniment of other reactions (see Fermentation, next chapter). But there is no doubt of its formation and it has been determined by a few investigators. On account of this use of carbon, bacteria require relatively large amounts of this element. One group of bacteria concerned in the spontaneous heating of coal seems to be able to use free carbon from this material. Another group is said to be able to oxidize marsh gas, CH,, and use this as its source of carbon. The nitrite, nitrate and sulphur bacteria mentioned later utilize carbon dioxide and carbonates as their carbon supply, and one kind has been described which uses carbon monoxide. With these few exceptions bacteria are dependent on organic compounds for their carbon and cannot use CO, as green plants do. The oxygen requirement is also high partly for the same reason that carbon is, 2. ¢., respiration. Oxygen is alos one of the constituents of protoplasm, and combined with hydrogen forms water which makes up such a large part of the living cell. Anaérobic bacteria are dependent on so- called “molecular respiration” for their energy. That. is, 78 CHEMICAL ENVIRONMENT through a shifting or rearrangement of the atoms in the compounds used as food the oxidation of carbon is brought about. Enzymes are probably responsible for this action. Carbon dioxide is produced by anaérobes as well as aérobes, and frequently in amounts readily collected. A carbohy- drate is usually though not always essential for the growth of anaérobes and serves them as the best source of energy. Nitrogen is the characteristic element of living material. Protoplasm is a chemical substance in unstable equilibrium and nitrogen is responsible for this instability. No other of the commoner elements is brought into combination with such difficulty, nor is so readily liberated when combined (all commercial explosives are nitrogen compounds). Bac- teria, like other forms of protoplasm, require nitrogen. More marked peculiarities are shown by bacteria with reference to the sources from which they derive their nitrogen than for carbon. Some can even combine the free nitrogen of the air and furnish the only natural means of any importance for this reaction. Some few forms (the nitrite and nitrate formers, Chapter XI) obtain their energy from the oxida- tion of inorganic nitrogen compounds, ammonia and nitrites respectively, and not from carbon. These latter bacteria use carbon from carbon dioxide and carbonates. A great many bacteria can secure their nitrogen from nitrates but some are restricted to organic nitrogen. Many bacteria obtain their carbon from the same organic compounds from which their nitrogen is derived. Sulphur serves mainly to supply this element in the protoplasmic structure. In some of the sulphur bacteria it is a source of energy, since either free sulphur or H2S is oxidized by them. Some of these bacteria can obtain their carbon from CO, or carbonates, and their nitrogen from nitrates or ammonium salts. Whether the tron bacteria, belonging to the genus Creno- thriz of the higher, thread bacteria, use this element or its compounds as sources of energy is still a disputed question. The evidence is largely in favor of this view. Free hydrogen has been shown to be oxidized by some forms which obtain their energy in this way. GENERAL FOOD RELATIONSHIPS—METABOLISM 79 Whether there is a special class of phosphorus bacteria remains to be discovered. That phosphorus is oxidized dur- ing the activity of many bacteria is undoubted, but whether this represents a source of energy or is the accidental by-product of other activities is undetermined. Practically nothing is known about the metabolism of the other elements as such. From the preceding brief review of the relation of certain bacteria to some of the elements in the free state and from the further fact that there is scarcely a known natural organic compound which cannot be utilized by some kind of bacterium, it is evident that this class of organisms has a far wider range of adaptability than any other class, and helps to explain their seemingly universal distribution. As to the metabolism within the cell, no more is known than is the case with other cells, nor even as much. The materials used for growth and as sources of energy are taken into the cell, built up into various compounds some of which have been enumerated and in part broken down again. Carbon dioxide and water are formed in the latter process. What other katabolic products occur it is not easy to determine. Certainly some of the substances mentioned in the next chapters are such products but it is not, always possible to separate those formed inside the cell from those formed outside. Perhaps most of the latter should be considered true metabolic products. It would seem that on account of the simplicity of structure of the bacterial cell and of the compounds which they may use as food they would serve as excellent objects for the study of the fundamental prob- lems of cell metabolism. Their minuteness and the nearly impossible task of separating them completely from the medium in or on which they are grown makes the solution of these problems one of great difficulty. When all of the environmental conditions necessary for the best development of a given bacterium are fulfilled, it will then develop to the limit of its capacity. This develop- ment is characterized essentially by its reproduction, which occurs by transverse division. The rate of this division varies much with the kind even under good conditions. 80 CHEMICAL ENVIRONMENT The most rapid rate so far observed is a division in eighteen minutes. A great many reproduce every half-hour and this may be taken as a good average rate. If such division could proceed without interruption, a little calculation will show that in about sixty-five hours a mass as large as the earth would be produced. Starting with 1 coccus, lu in diameter, its volume =0.0000000000005 c.c. } hour = 2 lhour = 4 2 hours = 16 4 hours = 256 5 hours = 1024 = 103 + 15 hours = 1,000,000,000 = 108 = 0.5 cc. 35 hours = 102+ = 500.0 cu.m. About 65 hours = 2 x 10+ = 5x 10 cu.m. = a mass as large as the earth. Such a rate of increase evidently cannot be kept up long on account of many limiting factors, chief of which is the food supply. The foregoing calculation is based on the assumption that the organism divides in one plane only. If it divides in 2 or 3 planes, the rate is much faster, as is shown by the following formule, which indicate the theoretical rate of division. s a number of bacteria after a given number of divisions number at the beginning, and n = number of divisions. 1 plane division S = 2"a Dos « § = 2" 3 «8 = 23% With two-plane or three-plane division, assuming that each organism attains full size, as was assumed in the first calcu- lation, the “mass as large as the earth” would be attained in about 32 hours and 22 hours respectively. This extraordinary rate of increase explains in large measure why bacteria are able to bring about such great chemical changes in so short a time as is seen in the rapid “spoiling” of food materials, especially liquids. The reac- tions brought about by bacteria on substances which are soluble and diffusible are essentially “surface reactions.” GENERAL FOOD RELATIONSHIPS—METABOLISM 81 The material diffuses into the cell over its entire surface with little hindrance. The bacteria are usually distributed throughout the medium, so that there is very intimate con- tact in all parts of the mass which favors rapid chemical action. The following calculation illustrates this: The volume of a coccus ly in diameter is 0.5236 x 1078 c.c. The surface of a coccus 1p in diameter is x 10-8 sq. cm. It is not uncommon to find in milk on the point of sour- ing 1,000,000,000 bacteria per c.c. Assuming these to be cocci of 1u diameter the volume of these bacteria in a liter is only 0.05-c.c. or in the liter there would be 19999 parts of milk and only 1 part bacteria. ‘The surface area of these bacteria is 3141.6 sq. cm. With this large surface exposed, it is not strange that the change from “on the point of souring” to “sour” occurs within an hour or less. Although large numbers of bacteria can and do cause great chemical changes the amount of material actually utilized for maintenance of the cell is very slight, infinites- imal almost, and yet is fairly comparable to that required for man, as is illustrated by the following computations: E. Kohn has shown that certain water bacteria grew well in water to which there was added per liter 0.000002 mg. dextrose, 0.00000007 mg. (NH4)2SO, and 0.0000000007 mg. (NHa)eHPO;. The bacteria numbered about 1000 per c.c. Taking the specific gravity at 1 (a little too low) the mass of the bacteria in the liter was about 0.001 mg. Hence the bacteria used 0.002 of their weight of carbohydrate and 0.00007 of ammonium sulphate. A 150-pound (75-kilo) man can live on 375 g. of sugar (0.005 of his weight) and 52.5 g. of protein (0.0007 of his weight). CHAPTER IX. PHYSIOLOGICAL ACTIVITIES. Tue objects in view in the discussion of the “ physiological activities” of bacteria in this and subsequent chapters are to familiarize the student to some extent with the great range of chemical changes brought about by these minute organisms, to show their usefulness, even their necessity, and to impress the fact that it is chiefly by a careful study of these “activities” that individual kinds of bacteria are identified. It should always be borne in mind that the bac- teria, in bringing about these changes which are so charac- teristic in many instances, are simply engaged in their own life struggle, in securing the elements which they need for growth, in liberating energy for vital processes, or occa- sionally in providing conditions which favor their own development and hinder that of their competitors. FERMENTATION OF CARBOHYDRATES. By this is meant the changes which different carbohy- drates undergo when subjected to bacterial action. These changes are marked chiefly by the production of gas or of acid.’ The former is called “ gaseous fermentation” the latter “acid fermentation.” The gases commonly pro- 1The term “fermentation’’ was originally used to denote the process which goes on in fruit juices or grain extracts when alcohol and gas are formed. Later it was extended to apply to the decomposition of almost -any organic substance. In recent years the attempt has been made to give a chemical definition to the word by restricting its use to those changes in which, by virtue of a ‘‘wandering” or rearrangement of the carbon atoms “‘new sub- stances are formed which are not constituents of the original molecule.” It may be doubted whether this restriction is justified or necessary. . Proteases, which split up proteins into proteoses and pep- tones. Other classes of “splitting enzymes” break up the prod- ucts of complex protein decomposition, such as proteoses, peptones and amino-acids. A variety of the “splitting enzymes” is the group of “Coagulases’’ or coagulating enzymes as the rennet (lab, chymosin) which curdles milk; fibrin ferment (thrombin, thrombase) which causes the coagulation of blood. These apparently act by splitting up a substance in the fluids mentioned, after which splitting one of the new products formed combines with other compounds present (usually a 1Tt will be noted that the names of enzymes (except some of those first discovered) terminate in ase which is usually added to the stem of the name of the substance acted on, though sometimes to a word which indicates the substance formed by the action, as lactacidase, alcoholase. PRODUCTION OF ENZYMES 113 mineral salt, and in the cases mentioned a calcium salt) to form an insoluble compound, the curd or coagulum. Another variety is the “activating” enzymes or “kinases” such as the enterokinase of the intestine. The action here is a splitting of the zymogen or mother substance, or form in which the enzyme is built up by the cell so as to liberate the active enzyme. Of a character quite distinct from the splitting enzymes are II. The zymases. Their action seems to be to cause a “shifting or rearrangement of the carbon atoms” so that new compounds are formed which are not assumed to have been constituents of the original molecule. Most commonly there is a closer combination of the carbon and oxygen atoms, frequently even the formation of CO, so that con- siderable energy is thus liberated. Examples are the zymase or alcoholase of yeast which converts sugar into alcohol and carbon dioxide; CeH»O, = 2C2H,O + 2COkz: also urease, which causes the change of urea into ammonia and carbon dioxide. Another common zymase is the lactacidase in lactic acid fermentation. III. Oxtdizing enzymes also play an important part in many of the activities of higher plants and animals. Among the bacteria this action is illustrated by the formation of nitrites, nitrates and sulphates and the oxidation of alcohol to acetic acid as already described. IV. Reducing enzymes occur in many of the denitrifying bacteria and in those which liberate H.S from sulphates. A. very widely distributed reducing enzyme is “catalase” which decomposes hydrogen peroxide. As previously stated, most of the physiological activities of bacteria are due to the enzymes that they produce. It is evident that for action to occur on substances which do not diffuse into the bacterial cell—starches, cellulose, com- plex proteins, gelatin—the enzymes must pass out of the bacterium and consequently may be found in the surround- ing medium. Substances like sugars, peptones, alcohol, which are readily diffusible, may be acted on by enzymes retained within the cell body. In the former case the 8 114 PHYSIOLOGICAL ACTIVITIES enzymes are spoken of as extra-cellular or “exo-enzymes,” and in the latter as intra-cellular or “endo-enzymes.” The endo-enzymes and doubtless also the exo-enzymes may after the death of the cell digest the contents to a greater or less extent and thus furnish substances that are not otherwise obtainable. This process of “self-digestion” is known tech- nically as “aztolysis.” A distinction was formerly made between “organized” and “unorganized ferments.” The former term was applied to the minute living organisms, bacteria, yeasts, molds, etc., which bring about characteristic fermentative changes, while the latter term was restricted to enzymes as just described. Since investigation has shown that the changes aseribed to the “organized ferments” are really due to their enzymes, and that enzymes are probably formed by all liv- ing cells, the distinction is scarcely necessary at present. PRODUCTION OF TOXINS. The injurious effects of pathogenic bacteria are due in large part to the action of these substances, which in many respects bear a close relationship to enzymes. The chemical composition is unknown since no toxin has been prepared “pure” as yet. It was formerly thought that they were protein in character, but very pure toxins have been pre- pared which failed to show the characteristic protein reac- tions. It is well established that they are complex sub- stances, of rather large molecule and are precipitated by many of the reagents which precipitate proteins. Toxins will be further discussed in Chapter XXVII. It will be sufficient at this point to enumerate their chief peculiarities ‘ in order to show their marked resemblance to enzymes. 1. Toxins are dead organic chemical substances. 2. They are always produced by living cells. 3. They are active poisons in very small quantities! 4, Their action is specific in that each toxin acts on a particular kind of cell. The fact that a so-called toxin acts 1 Tetanus toxin is about 120 times as poisonous as strychnin, both of which act on the same kind of nerve cells. PRODUCTION OF TOXINS 115 on several different kinds of cells, possibly indicates a mix- ture of several toxins, or action on the same substance in the cells. 5. Toxins are very sensitive to the action of injurious agencies such as heat, light, etc., and in about the same measure that enzymes are, though as a rule they are some- what more sensitive or “labile.” 6. Toxins apparently have maxima, optima, and minima of temperature for their action, as shown by the destructive effect of heat and by the fact that a frog injected with tetanus toxin and kept at 20° shows no indication of poison, but if the temperature is raised to 37,° symptoms of poisoning are soon apparent. Cold, however, does not destroy a toxin. 7. When properly introduced into the tissues of animals they cause the body cells to form antitoxins (Chapter XXVIJ) which are capable of preventing the action of the toxin in question. 8. The determining test for a toxin rs its action on a living cell. It is true that enzymes are toxic, as are also various foreign proteins, when injected into an animal, but in much larger doses than are toxins. A marked difference between enzymes and toxins is that the former may bring about a very great chemical change and still may be recovered from the mixture of substances acted on and produced, while the toxin seems to be perma- nently used up in its toxic action and cannot be so recovered. Toxins seem very much like enzymes whose action is restricted to ling cells. Just as enzymes are probably produced by all kinds of cells and not by bacteria alone, so toxins are produced by other organisms. Among toxins which have been care- fully studied are ricin, the poison of the castor oil plant (Ricinus communis); abrin of the jequirity bean (Abrus pre- catorius); robin of the common locust (Robinia pseudacacia) ; poisons of spiders, scorpions, bees, fish, snakes and sala- manders. It has been stated that. some enzymes are thrown out from the cell and others are retained within the cell. The 116 PHYSIOLOGICAL ACTIVITIES same is true of toxins, hence we speak of exo-toxins or toxins excreted from, and endo-toxins or toxins retained within the cell. Among the pathogenic bacteria there are very few which secrete toxins when growing outside the body. Bacillus tetant or lockjaw bacillus, Bactertwm diphtherie or the diphtheria bacillus, Bacillus botulinus or a bacillus caus- ing a type of meat poisoning, Pseudomonas pyocyanea or the blue pus bacillus are the most important. Other pathogenic bacteria do not secrete their toxins under the above condi- tions, but only give them up when the cell is disintegrated either within or outside the body. For the reason that endotoxins are therefore difficult to obtain their character- istics have not been much studied. The description of toxins as above given is intended to apply to the exotorins of bacteria, sometimes spoken of as true toxins, and to the vegetable toxins (phytotoxins) which resemble them. The snake venoms and probably most of the animal toxins (zoétoxins) are very different substances. (See Chapter XXIX.) CAUSATION OF DISEASE. This subject belongs properly in special pathogenic bac- teriology. It will be sufficient to indicate that bacteria may cause disease in one or more of the following ways: (a) blocking circulatory vessels, either blood or lymph, directly or indirectly; (b) destruction of tissue; (c) production of non-specific poisons (ptomaines, bases, nitrites, acids, gases, etc.); (d) production of specific poisons (toxins). ANTIBODY FORMATION. Bacteria cause the formation of specific “antibodies” when properly introduced into animals. This must be considered as a physiological activity since it is by means of substances produced within the bacterial cell that the body cells of animals are stimulated to form antibodies. (See Chapters XXVI-XXIX.) CULTURAL CHARACTERISTICS 117 STAINING. The reaction of bacteria to various stains is dependent on their physicochemical structure and hence is a result of physiological processes, but is best discussed separately (Chapter XIX). CULTURAL CHARACTERISTICS. The same is true of the appearance and growth on different culture media. (Chapter XX.) CHAPTER XIII. DISINFECTION—STERILIZATION— DISINFECTANTS. TuE discussion of the physiology of bacteria in the pre- ceding chapters has shown that a number of environmental factors must be properly correlated in order that a given organism may thrive. Conversely, it can be stated that any one of these environmental factors may be so varied that the organism will be more or less injured, may even be destroyed by such variation. It has been the thorough study of the above-mentioned relationships which has led to prac- tical methods for destroying bacteria, for removing them or preventing their growth when such procedures become necessary. The process of killing all the living organisms or of remov- ing them completely is spoken of as disinfection or as sterili- zation, according to circumstances. Thus the latter term is applied largely in the laboratory, while the former more generally in practice outside the laboratory. So also disin- fection is most commonly done with chemical agents and sterilization by physical means, though exceptions are numerous. The original idea of disinfection was the destruc- tion of “infective” organisms, that is, organisms producing disease in man or animals. A wider knowledge of bacteri- ology has led to the application of the term to the destruc- tion of other organisms as well. Thus the cheese-maker “disinfects” his curing rooms to prevent: abnormal ripening of cheese, and the dairy-worker “disinfects” his premises to avoid bad flavors, abnormal changes in the butter or milk. Sterilization is more commonly applied to relatively small objects and disinfection to larger ones. Thus in the labor- atory, instruments, glassware, apparatus, etc., are ‘‘steril- ized” while desks, walls and floors are “disinfected.'' The PHYSICAL AGENTS 119 surgeon “‘sterilizes” his instruments, but “disinfects’” his operating table and room. The dairy-workers mentioned , above sterilize their apparatus, pails, milk bottles, ete. Evidently the object of the two processes is the same, remov- ing or destroying living organisms, the name to be applied: is largely a question of usage and circumstances. Any agent which is used to destroy microérganisms is called a “disin- fectant.” Material freed from living organisms is “sterile.”’ The process of preventing the growth of organisms without reference to whether they are killed or removed is spoken of as “antisepsis,” and the agent as an antiseptic. Hence a mildly applied “disinfectant” becomes an “antiseptic,” though it does not necessarily follow that an “antiseptic” may become a disinfectant when used abundantly. Thus strong sugar solutions prevent the development of many organisms, though they do not necessarily kill them. Asepsis is a term which is restricted almost entirely to surgical operations and implies the taking of such precau- tions that foreign organisms are kept out of the field of opera- tion. Such an operation is an aseptic one, or performed aseptically. A “deodorant or deodorizer”’ is used to destroy or remove an odor and does not necessarily have either antiseptic or disinfectant properties. The agents which are used for the above-described pro- cesses may be conveniently divided into physical agents and chemical agents. PHYSICAL AGENTS. 1. Drying.—This is doubtless the oldest method for pre- venting the growth of organisms, and the one which is used on the greatest amount of material at the present time. A very large percentage of commercial products is preserved and transported intact because the substances are kept free from moisture. In the laboratory many materials which are used as food for bacteria (see Chapter XVI) “keep” because they are dry. Nevertheless, drying should be con- sidered as an antiseptic rather than as a disinfectant process. While it is true that the complete removal of water would 120 DISINFECTION—STERILIZATION—DISINFECTANTS result in the death of all organisms this necessitates a high temperature, in itself destructive, and does not occur in practice. Further, though many pathogenic bacteria are killed by drying, many more, including the spore formers, are not. Hence drying alone is not a practical method of disinfecting. 2. Heat.—The use of heat in some form is one of the very best means for destroying bacteria. It may be made use of by combustion, or burning, as direct exposure to the open flame, as dry heat (hot air), or as moist heat (boiling Fic. 76.—A small laboratory hot-air sterilizer. water or steam). Very frequently in veterinary practice, especially in the country, occasionally under other condi- tions, the infected material is best burned. This method is thoroughly effective and frequently the cheapest in the end. Wherever there are no valid objections it should be used. Exposure to the open flame is largely a laboratory procedure to sterilize small metallic instruments and even small pieces of glassware. It is an excellent procedure in postmortem examinations to burn off the surface of the body or of an organ when it is desired to obtain bacteria from the interior free from contamination with surface organisms. PHYSICAL AGENTS 121 Dry Heat—Dry heat is not nearly so effective as moist heat as a sterilizing agent. The temperature must be higher and continued longer to accomplish the same result. Thus a dry heat of 150° for thirty minutes is no more efficient than steam under pressure at 115° for fifteen minutes. Various forms of hot-air sterilizers are made for laboratory purposes (Fig. 76). On account of the greater length of time required for sterilization their use is more and more restricted to objects which must be used dry, as in blood and serum work, for example. In practice the use of hot air in disin- fecting plants is now largely restricted to objects which might be injured by steam, as leather goods, furs, and certain articles of furniture, but even here chemical agents are more frequently used. Moist Heat—Moist heat may be applied either by boil- ing in water or by the use of steam at air pressure, or, for rapid work and on substances that would not be injured, by steam under pressure. Boiling is perhaps the best house- hold method for disinfecting all material which can be so treated. The method is simple, can always be made use of, and is universally understood. It must be remembered that all pathogenic organisms, even their spores are destroyed by a few minutes’ boiling. The process may be applied to more resistant organisms, such as are met with in canning vegetables, though the boiling must be continued for several hours, or what is better, repeated on several different days. This latter process, known as “discontinuous sterilzation,” must also be applied to substances which would be injured or changed in composition by too long-continued heating, such as gelatin, milk, and certain sugars. In the laboratory such materials are boiled or subjected to streaming steam for half an hour on each of three successive days. In can- ning vegetables the boiling should be from one to two hours each day. The principle involved is that the first boiling destroys the growing cells, but not all spores. Some of the latter germinate by the next day and are then killed by the second boiling and the remainder develop and are killed on the third day. Occasionally a fourth boiling is necessary. It is also true that repeated heating and cooling is more 122 DISINFECTION—STERILIZATION—DISINFECTANTS destructive to bacteria than continuous heating for the same length of time, but the development of the spores is the most important factor. Discontinuous heating may also be used at temperatures below the boiling-point for the sterilization of fluids like blood serum which would be coagulated by boiling. In this case the material is heated at 55° to 56° for one hour, but on each of seven to ten successive days. The intermittent heating and cooling is of the same impor- tance as the development of the spores in this case. (Better results are secured with such substances by collecting them aseptically in the first place.) Fig. 77.—The Arnold steam sterilizer for laboratory use. Steam.—Steam is one of the most commonly employed agents for sterilization and disinfection. It is used either as “streaming steam” at air pressure or confined under pressure so that the temperature is raised. For almost all purposes where boiling is applicable streaming steam may be substituted. It is just as efficient and frequently more easily applied. The principle of the numerous forms of “steam sterilizers” (Fig. 77) is essentially the same. There PHYSICAL AGENTS 123 is a receptacle for a relatively small quantity of water and means for conducting the steam generated by boiling this water to the objects to be treated, which are usually placed il \é [ae ~ af = al Fic. 78.—Vertical gas-heated Fig. 79.—Horizontal gas-heated labora- laboratory autoclave. tory autoclave. 124. DISINFECTION—STERILIZATION—DISINFECTANTS immediately above the water. Surgical instruments may be most conveniently sterilized by boiling or by steaming in especially constructed instrument sterilizers. If boiled, the addition of carbonate of soda, about 1 per cent., usually prevents injury. Fig. 80.—A battery of two horizontal autoclaves in one of the author's student laboratories. Steam is furnished direct from the University central heating plant. Steam under pressure affords a much more rapid and cer- tain method of destroying organisms. Fifteen to twenty pounds’ pressure corresponding to temperatures of 121° to 125° is commonly used. Variations depend on the bulk and nature of the material. Apparatus for this purpose may now be obtained from sizes as.small as one or two gallons up to huge structures which will take one or two truckloads of PHYSICAL AGENTS 125 material (Figs. 78-90). The latter type is in common use in canning factoties, dairy plants, hospitals, public institu- tions, municipal and governmental disinfecting stations. Very frequently there is an apparatus attached for pro- ducing a vacuum both to exhaust the air before sterilizing, so that the steam penetrates much more quickly and thor- oughly and for removing the vapor after sterilizing, thus hastening the drying out of the material disinfected. Fig. $1.—A ‘‘process kettle’’ (steam-pressure sterilizer) used in canning. Diameter, 40 inches; height, 72 inches. The smaller types of pressure sterilizers are called “auto- claves’ and have become indispensable in laboratory work. Fifteen pounds’ pressure maintained for fifteen minutes is commonly sufficient for a few small objects. For larger masses much longer time is needed. The author found that in an autoclave of the type shown in Fig. 79 it required ten minutes for 500 c:c. of water at 15 pounds’ pressure to reach 126 DISINFECTION—STERILIZATION—DISINFECTANTS a temperature of 100°, starting at room temperatures, 20° to 25°. Autoclaves may be used as simple steam sterilizers by Fic. $2.—Horizontal steam chest used in canning. Height, 32 inches; width, 28 inches; length, 10 feet. leaving the escape valves open so that the steam is not confined, hence they have largely replaced the latter.' 1In the author's laboratory in the past ten years all sterilization except those few objects in blood and serum work which must be dry, has been done in autoclaves of the type shown in Fig. 80 which are supplied with steam from the University central heating plant. A very great saving of time is thus secured. PHYSICAL AGENTS 127 A process closely akin to sterilization by heat is pasteur- ization. This means the heating of material at a tempera- ture and for a time which will destroy the actively growing bacteria but notgthe spores. The methods for doing this Fig. 83.—A battery of horizontal rectangular steam chests in actual use in a canning factory. 128 DISINFECTION—STERILIZATION—DISINFECTANTS vary but are essentially two in principle. 1. The material in small quantities in suitable containers (bottles) is placed in the apparatus; the temperature is raised to 60° to 65° and maintained for twenty to thirty minutes and then the whole Fic. §4.—A battery of cylindrical process kettles in actual use in a canning factory. ’ PHYSICAL AGENTS 129 is cooled (beer, wine, grape juice, bottled milk) (Figs. 91, 92, and 93). Fic. 85.—A steam chamber used in government disinfection work. Size, 4 feet 4 inches x 5 feet 4 inches x 9 feet. Fig. 86.—Circular steam chamber used in government disinfection work, 54 inches in diameter. 2. Pasteurizing machines are used and the fluid flows through continuously. In one type the temperature is raised 9 130 DISINFECTION—STERILIZATION—DISINFECTANTS Fig. 88.—Steam chambers on deck of the U. S. quarantine station barge “Defender.” PHYSICAL AGENTS 131 to 60° and by “retarders” is kept at this temperature for twenty to thirty minutes (Figs. 94 to97). In another type the Fic. 89.—Steam chambers in hold of U. 8. quarantine station barge ‘‘ Pro- tector.’ Disinfected space. Fie. 90.—Municipal disinfecting station, Washington, D. ©, Fic. 92.—A pasteurizer for PHYSICAL AGENTS 133 temperature is raised to as high as 85° for a few seconds only, “flash process” (Fig. 98), and then the material is rapidly Fic. 94.—A continuous milk pasteurizer. 134 DISINFECTION—STERILIZATION—DISINFECTANTS cooled. Itiscertain that all pathogenic microérganisms, except the very few spore formers in that stage, are killed by proper Fic. 95.—A pasteurizer for cream to be used in making ice-cream. pasteurization. The process is largely employed in the fermentation and dairy industries. Fic. 96.—A continuous milk pasteurizer with holder; capacity, 1500 pounds per hour. A, pasteurizer—the milk flows in tubes inside of a jacket of water heated to the proper temperature; B, holder; C, water cooler; D, brine cooler. Fic. 97.—A continuous pasteurizing plant in operation. Similar to Fig. 96, but larger. Capacity, 12,000 pounds per hour. A, pasteurizer; B, seven compartment holder; C, D, coolers. 136 DISINFECTION—STERILIZATION—DISINFECTANTS 3. Cold.—That cold is an excellent antiseptic is illustrated by the general use of refrigerators and “cold storage.” Numerous experiments have shown that although many pathogenic organisms of a given kind are killed by tempera- tures below freezing, not all of the same kind are, and many kinds are only slightly affected. Hence cold cannot be con- sidered a practical means for disinfection. Fig. 98.—A ‘flash process” pasteurizing outfit, with holder. A, flash pasteurizer; B, holder; C, cooler. 4, Light.—It has been stated (p. 65) that light is destruc- tive to bacteria, and the advisability of having well-lighted habitations for men and animals has been mentioned. The practice of “sunning” bedclothing, hangings and other large articles which can scarcely be disinfected in a more con- venient way is the usual method of employing this agent. Drying and the action of the oxygen of the air assist the process to some extent. Undoubtedly large numbers of pathogenic organisms are destroyed under natural condi- tions by the combined effects of drying, direct sunlight and PHYSICAL AGENTS 137 oxidation, but it should not be forgotten that a very slight protection will prevent the action of light (Figs. 99 and 100). 5. Osmotic Pressure.—Increase in the concentration of substances in solution is in practical use as an antiseptic procedure. Various kinds of “sugar preserves,” salt meats and condensed milk are illustrations. It must be remem- bered that a similar increase in concentration occurs when Fig. 99.—Effect of light on bacteria. 7/10. The plate was inoculated in the usual way. A letter H of black paper was pasted on the bottom. The plate was then exposed for four hours to the sun in January outside the window and then incubated. The black paper protected the bacteria. Outside of it they were killed except where they happened to be in large masses. Hence the letter shows distinctly. (Student preparation.) many substances are dried, and is probably as valuable in the preservative action as the loss of water. That the pro- cess cannot be depended on to kill even pathogenic organ- isms is shown by finding living tubercle bacilli in condensed milk. The placing of bacteria in water or in salt solution in order to have them die and disintegrate (greatly aided. by vigorous shaking in a shaking machine) (“autolysis,’’ 1388 DISINFECTION—STERILIZATION—DISINFECTANTS p- 114) is a laboratory procedure to obtain cell constituents. It is not a practical method of disinfection, however. 6. Electricity.—Electricity, though not in itself injurious to bacteria, is used as an indirect means for destroying bac- teria in a practical way. This is done by electrical produc- tion of some substance which is destructive to bacteria as in ozone water purification (Petrograd, Florence, and else- Fie. 100.—Effect of light on bacteria. XX 7/10. This plate was treated exactly as the plate in Fig. 99, except that the letter is ZL, and that it was exposed inside the window and wire screen. The window was plate glass. It is evident that few of the bacteria were killed, since the letter Z is barely outlined. The exposure was at the same time as the plate in Fig. 99. (Stu- dent preparation.) where), or the use of ultra-violet rays for the same purpose (Marseilles, Paris) and for treatment of certain disease con- ditions. Electricity might be used as a source of heat for disinfecting purposes should its cheapness justify it. It has also been used in the preservation of meats to hasten the penetration of the salt and thus reduce the time of pickling. Electrolyzed sea water has been tried as a means of flushing PHYSICAL AGENTS 139 Fic. 101.—An electric milk purifier (pasteurizer). The milk flowing from cup to cup completes the circuit when the current is on. The effect is certainly a heat effect. Sparking occurs at the lips of the cups. Fig. 102.—One of the ten filter beds of the Columbus water filtration plant with the filtering material removed. Sand is the filtering material. All of the beds together have a capacity of 30,000,000 gallons daily. 140 DISINFECTION—STERILIZATION—DISINFECTANTS and disinfecting streets, but it is very doubtful if the ‘waded expense is justified by any increased benefit. A number of electric devices have been put forth for various sterilizing and disinfecting purposes and doubtless will continue to be, but everyone should be carefully tested before money is invested in it. Fig. 103.—Suction filtration. A, Berkefeld filter in glass cylinder con- taining the liquid to be filtered; B, sterile flask to receive the filtrate as it is drawn through; C, water pump; D, manometer, convenient for detecting leaks as well as showing pressure; FE, bottle for reflux water. 7. Filtration Filtration is a process for rendering fluids sterile by passing them through some material which will 1 The author has tested an ‘electric milk purifier’ (Fig. 101) which was as efficient as a first-class pasteurizer and left the milk in excellent condi- tion both chemically and as far as ‘‘cream line” was concerned. The cost of operation as compared with steam will depend on the price of electricity. PHYSICAL AGENTS 141 hold back the bacteria. It is used on a large scale in the purification of water for sanitary or manufacturing reasons (Fig. 102). Airis also rendered “germ free” in some surgical operating rooms, “serum laboratories’ and breweries by filtra- tion. Inthe laboratory it isa very common method of steriliz- ing liquids which would be injured by any other process. The i et ) ia Fic. 104.—Pressure filtration. A, cylinder which contains the filter candle; B, cylinder for the liquid to be filtered; C, sterile flask to receive the filtrate; D, air pump to furnish pressure. apparatus consists of a porous cylinder with proper devices for causing the liquid to pass through either by suction (Fig. 103), where the pressure will be only one atmosphere’ (approximately 15 pounds per square inch), or by the use of compressed air at any desired pressure (Fig. 104). The two main types of porous cylinders (“filter candles,”’ “bougies’’) 142 DISINFECTION—STERILIZATION—DISINFECTANTS are the Pasteur-Chamberland (Fig. 105) and the Berkefeld. The former are made of unglazed porcelain of different degrees of fineness, the latter of diatomaceous earth (Fig. 106). The designs of complete apparatus are numerous. 8. Burying.—This is a time-honored method of disposing of infected material of all kinds and at first thought might not be considered a means of disinfection. As a matter of fact, under favorable conditions it is an excellent method. Fig. 105.—Pasteur-Chamberland filter candles about one-half natural size. The infected material is removed. Pathogenic organisms tend to die out in the soil owing to an unfavorable environ- ment as to temperature and food supply, competition with natural soil organisms for what food there is, and the injuri- ous effects of the products of these organisms. Care must be taken that the burial is done in such a way that the surface soil is not contaminated either directly or by material brought up from below by digging or burrowing animals, insects, PHYSICAL AGENTS 143 worms, or movement of ground water to the surface. Also that the underground water supply which is drawn upon for use by men or animals is not also contaminated. Fre- Fic. 106.—Berkefeld filter candles about one-half natural size. quently infected material, carcasses of animals, etc., are treated in some way so as to aid the natural process of destruction of the organisms present, especially by the use of certain chemical agents, as quicklime (see p. 146). CHAPTER XIV. DISINFECTION AND STERILIZATION (ConTINUED). CHEMICAL AGENTS. A very large number of chemical substances might be used for destroying bacteria or preventing their growth either through direct injurious action or by the effect of concentration. Those which are practically useful are rela- tively few, though this is one of the commonest methods of disinfecting and the word “disinfectant” is frequently wrongly restricted to chemical agents. Chemical agents act on bacteria in a variety of ways. Most commonly there is direct union of the chemical with the protoplasm of the cell and consequent injury. Some- timeés the chemical is first precipitated on the surface of the cell without penetrating at once. If removed soon enough, the organism is not destroyed. This is true of bichloride of mercury and formaldehyde. If bacteria treated with these agents in injurious strength be washed with ammonia or ammonium sulphate, even after a time which would other- wise result in their failure to grow, they will develop. Some chemicals change the reaction of the material in a direction unfavorable to growth, and if the change is enough, may even kill the bacteria. Some agents remove a chemical substance necessary to the growth of the organism and hence inhibit it. Such actions are mainly preventive (anti- septic) and become disinfectant only after a long time. ELEMENTS. Oxygen.—Oxygen as it occurs in the air is probably not injurious to living bacteria but aids them with the excep- ELEMENTS 145 tion of the anaérobes. In the nascent state especially as liberated from ozone (O3) hydrogen peroxide (H,O.) and hypochlorites (Ca(CI1O).) it is strongly bactericidal. Fig. 107.—Apparatus for sterilizing water with liquid chlorine. Chlorine.—Chlorine is actively disinfectant and is coming into use for sterilizing water on a large scale in municipal plants (Fig. 107). Jodine finds extended use in aseptic sur- gical operations and antiseptic dressings. Bromine, mer- cury, silver, gold, nickel, zine and copper are markedly germicidal in the elemental state but are not practical. 10 146 DISINFECTION AND STERILIZATION COMPOUNDS. Calcium Oxide.—Calcium oxide (CaO), quick lume, is an excellent disinfectant for stables, yards, outhouses, etc., where it is used in the freshly slaked condition as “white wash;” also to disinfect carcasses to be buried. It is very efficient against the typhoid bacillus in water, where it is much used to assist in the softening. Chloride of Lime.—Chloride of lime, bleaching powder, which consists of calcium hypochlorite, the active agent, and chloride and some unchanged quicklime is one of the most useful disinfectants. It is employed to sterilize water for drinking purposes on a large scale and to disinfect sewage plant effluents. A 5 per cent. solution is the proper strength for ordinary disinfection. Only a supply which is fresh or has been kept in air-tight containers should be used, as it rapidly loses strength on exposure to the air. The active agent is nascent oxygen liberated from the decomposition of the hypochlorite. Sodium Hypochlorite—Sodium hypochlorite prepared by the electrolysis of common salt has been used to some extent. Bichloride of Mercury—Bichloride of mercury, mercuric chloride, corrosive sublimate (HgClz), is the strongest of all disinfectants under proper conditions. It is also extremely poisonous to men and animals and great care is necessary in its use. It is precipitated by albuminous substances and attacks metallic objects, hence should not be used in the presence of these classes of substances. It is used in a strength of one part HgCl, to 1000 of water for general disinfection. Ammonium chloride or sodium chloride, common salt, in quantities equal to the bichloride, or citric acid in one-half of the amount should be added in making large quantities of solution or for use with albumin- ous fluids to prevent precipitation of the mercury (Fig. 108). None of the other metallic salts are of value as practical disinfectants aside from their use in surgical practice. In this latter class come boric acid, silver nitrate, potassium permanganate. The strong mineral acids and alkalis are, of course, destructive to bacteria, but their corrosive effect ORGANIC COMPOUNDS 147 excludes them from practical use, except that “lye washes” are of value in cleaning floors and rough wood-work, but even here better disinfection can be done more easily and safely. Fie. 108.—Tanks for bichloride of mercury, government quarantine disinfecting plant. ‘ ORGANIC COMPOUNDS. Carbolic Acid or Phenol.—Carbolic acid or phenol (CsH;OH) is one of the commonest agents in this class. It is used mostly in 5 per cent. solution as a disinfectant and in 0.5 per cent. solution as an antiseptic. For use in large quanti- ties the crude is much cheaper and, according to some experi- menters, even more active than the pure acid, owing to the cresols it contains. The crude acid is commonly mixed with an equal volume of commercial sulphuric acid and the mix- ture is added to enough water to make a 5 per cent. dilution, which is stronger than either of the ingredients alone in 5 per cent. solution. Cresols—The cresols (CsH,CH;OH, ortho, meta and para), coal-tar derivatives, as phenol, are apparently more powerful disinfectants. A great number of preparations 148 DISINFECTION AND STERILIZATION containing them have been put on the market. Creolin is one which is very much used in veterinary practice and forms a milky fluid with water, while lysol forms a clear frothy liquid. Both of these appear to be more active than carbolic acid and are less poisonous and more agreeable to use. They are used in 2 to 5 per cent. solution. Alcohol Ordinary (ethyl) alcohol (C,H;OH) is largely used as a preservative, also as a disinfectant for the body surface, hands, and arms. Experiments show that alcohol of 70 per cent. strength is most strongly bactericidal and that absolute alcohol is very slightly so. Soap.—Experimenters have obtained many conflicting results with soaps when tested on different organisms, as is to be expected from the great variations in this article. Miss Vera McCoy in the author’s laboratory carried out experiments with nine commercial soaps—Ivory, Naphtha, Packer’s Tar, Grandpa’s Tar, Balsam Peru, A. D. 5. Car- bolic, German Green, Dutch Cleanser, Sapolio—and_ ob- tained abundant growth from spores of Bacterium anthracis, from Bacillus coli and from Micrococcus pyogenes aureus in all cases even when the organisms had been exposed twenty- four hours in 5 per cent. solutions. From these results and from the wide variations reported in the literature it is clear that soap solutions alone cannot be depended on as dis- infectants. Medicated soaps do not appear to offer any advantages in this respect. Formaldehyde.—Formaldehyde (HCHO) is perhaps the most largely used chemical disinfectant at the present time. The substance is a gas but occurs most commonly in com- merce as a watery solution containing approximately 40 per cent. of the gas. This solution is variously known as formalin, formol, and formaldehyde solution. The first two names are patented and the substance under these names usually costs more. It is used in the gaseous form for disin- fecting closed spaces of all kinds to the exclusion of most other means today. A great many types of formalin gen- erators have been devised. The gas has little power of penetration and all material to be reached should be exposed as much as possible, The dry gas is almost ineffective, so ORGANIC COMPOUNDS 149 that the objects must be moistened or vapor generated along with the gas. A common method in use is to avoid expensive generators by pouring the formaldehyde solution on permanganate of potash crystals placed in a_ vessel removed from inflammable objects on account of the heat developed which occasionally, sets the gas on fire. The formalin is used in amounts varying from 20 to 32 ounces to 84 to 13 ounces of permanganate to each 1000 cubic feet of space. This method is expensive since one pint (16 ounces) of formalin is sufficient for each 1000 cubic feet, and since the permanganate is an added expense. Dr. Dixon, Commis- sioner of Health of Pennsylvania, recommends the following mixture to replace the permanganate, claiming that it works more rapidly and is less expensive and just as efficient: 1. Sodium bichromate, ten ounces. 2. Saturated solution of formaldehyde, sixteen ounces. 3. Common sulphuric acid, one and a half ounces. Two and three are mixed together and when cool are poured on the bichromate which is placed in an earthen- ware jar of a volume about ten times the quantity of fluid used. The quantities given are for each 1000 cubic feet of space. A very simple method is to cause the formalin, diluted about twice with water, to furnish moisture enough to drop, by means of a regulated “separator funnel’ on a heated iron plate. The dropping should be so regulated that each drop is vaporized as it falls. The plate must have raised edges, pan-shaped, to prevent the drops rolling off when they first strike the plate. Formaldehyde has no corrosive (except on iron) or bleaching action, and is the most nearly ideal closed space disinfectant today. In disinfecting stations it is made use of in closed sterilizers such as were described under steam disinfection, particularly in connection with vacuum apparatus. It is also used in solution as a pre- servative and as a disinfectant. The commonest strength is 2 or 3 per cent. of formalin or 0.8 to 1.2 per cent. of the formaldehyde gas. As an antiseptic it is efficient in dilutions as high as 1 to 2000 of the gas. It is very irritant to mucous membranes of most individuals. 150 DISINFECTION AND STERILIZATION In addition to the above-discussed disinfectants a large number of substances, particularly organic, are used in medicine, surgery, dentistry, etc., as more or less strong antiseptics, and the list is a constantly lengthening one. In the laboratory chloroform, H,O:, ether and other vola- tile or easily decomposable substances have been used to sterilize liquids which could not be treated by heat or by filtration. The agent is removed either by slow evapora- tion or by exhausting the fluid with an air pump. The method is not very satisfactory, nor is absolute steriliza- tion easily accomplished. It is much better to secure such liquids aseptically where possible. CHAPTER XV. DISINFECTION AND STERILIZATION (ConrinueEp). CHOICE OF AGENT. THE choice of the above-described agents depends on the conditions. Evidently a barn is not to be disinfected in the same way that a test-tube in the laboratory is sterilized. - Among the factors to be considered in making a choice are the thing to be disinfected or sterilized, its size and nature, that is, whether it will be injured by the process proposed, cost of the agent, especially when a large amount of material is to be treated. Among the conditions which affect the action of all agents the following should be borne in mind particularly when testing the disinfecting power of chemical agents: 1. The kind of bacterium to be destroyed, since some are more readily killed by a given disinfectant than others, even though no spores are present. 2. The age of the culture. Young bacteria less than twenty- four hours old are usually more readily killed than older ones since the cell wall is more delicate and more easily pene- trated, though old growths may be weakened by the accu- mulation of their products and be more easily destroyed. 3. Presence of spores, since they are much more resistant than the growing cells. 4, Whether the organism is a “good or bad” growth, 1. e., whether it has grown in a favorable environment and hence is vigorous, or under unfavorable conditions and hence is weak. 5. The number of bacteria present, since with chemical agents the action is one of relative masses. 6. Nature of the substance in which the bacteria are. Metallic salts, especially bichloride of mercury, are precipi- tated by albuminous substances and if employed at all must 152 DISINFECTION AND STERILIZATION be used in several times the ordinary strength. Solids require relatively more of a given solution than liquids. 7. State of the disinfectant, whether solid, liquid or gas, and whether it is ionized or not. Solutions penetrate best and are therefore more quickly active and more efficient. 8. The solvent. Water is the best solvent to use. Strong alcohol (90 per cent. +) diminishes the effect of carbolic acid, formaldehyde and bichloride of mercury. Oil has a similar effect. The action is probably to prevent the pene- tration of the disinfectant. 9. Strength of solution. The stronger the solution, the more rapid and more certain the action, for the same rea- son as mentioned under 5. In fact, every disinfectant has a strength below the lethal at which it stimulates bacterial growth. 10. Addition of salts. Common salt favors the action of bichloride of mercury and also of carbolic acid. Other salts may hinder by precipitating the disinfectant. 11. Temperature. Chemical disinfectants, as a rule, fol- low the general law that chemical action increases with the temperature, up to the point where the heat of itself is sufficient to kill. 12. Time of action. It is scarcely necessary to point out that a certain length of time is necessary for any disinfec- tant to act. One may touch a red hot stove and not be burned. All the above-mentioned conditions are influenced by the time of action. PRACTICAL STERILIZATION AND DISINFECTION. The methods for sterilizing in the laboratory have been discussed and will be referred to again in the next chapter. _ In practical disinfection it is a good plan always to pro- ceed as though spores were present even if the organism is known. Hence use an abundance of the agent and apply it as long as practicable. Also it is best to secure the chemical substances used as such and not depend on patented mixtures purporting to contain them. As a rule the latter are more expensive in proportion to the results secured. PRACTICAL STERILIZATION AND DISINFECTION 153 Surgical instruments may be sterilized by boiling in water for fifteen minutes, provided they are’ clean, as they should be. If dried blood, pus, mucus, etc., are adherent, which should never be the case, they should be boiled one-half hour. The addition of sodium carbonate (0.5 to 1 per cent.) prevents rusting. Surgeon’s sterilizers are to be had at reasonable prices and are very convenient. Whether the instruments are boiled or subjected to streaming steam depends on whether the supporting tray is covered with water or not. The author finds it a good plan to keep the needles of hypodermic syringes in a small wire basket in an oil bath. The oil may be heated to 150° to 200° and the needles sterilized in a very few minutes. The oil also prevents rusting. Rooms, offices and all spaces which may be readily made practically gas-tight are best disinfected by means of for- maldehyde by any of the methods above described (Figs. 109 and 110). Stables and Barnyards (Mohler): “A preliminary cleaning up of all litter is advisable together with the scraping of the floor, mangers, and walls of the stable with hoes and the removal of all dust and filth. All this material should be burned since it probably contains the infective agent. Heat may be applied to the surfaces, including barnyard, by means of a ‘cyclone oil burner.’ When such burning is impracti- cable, the walls may be disinfected with one of the following: “1. Whitewash 1 gallon + chloride of lime 6 ounces. “2. Whitewash 1 gallon + crude carbolic acid 7 ounces. “3. Whitewash 1 gallon + formalin 4 ounces. The same may be applied with brushes or, more rapidly, sprayed on with a pump; the surface soil of the yard and surroundings should be removed to a depth of 5 or 6 inches, placed in a heap and thoroughly mixed with quicklime. The fresh surface of soil thus exposed may be sprinkled with a solution of a chemical disinfectant as above described. “Portions of walls and ceiling not readily accessible may be disinfected by chlorine gas liberated from chloride of lime by crude carbolic acid. This is accomplished by mak- ing a cone of 5 or 6 pounds of chloride of lime in the top of 154 DISINFECTION AND STERILIZATION which a deep crater is made for the placement of from 1 to 2 pints of crude carbolic acid. The edge of the crater is thereupon pushed into the fluid, when a lively reaction fol- lows. Owing to the heat generated, it is advisable to place Fig. 109. — Formaldehyde generator used in city work for Fig. 110. — Government formalde- room disinfection. hyde generator. the chloride of lime in an iron crucible (pot), and to have nothing inflammable within a radius of two feet. The num- ber and location of these cones of chloride of lime depend on the size and structure of the building to be disinfected. PRACTICAL STERILIZATION AND DISINFECTION 155 As a rule it may be stated that chlorine gas liberated from the above sized cone will be sufficient for disinfecting 5200 cubic feet of air space.” Inquid manure, leachings, etc., where collected are thor- oughly disinfected by chloride of lime applied in the pro- portion of 2 parts to 1000 of fluid. Vehicles may be thoroughly washed with 2 per cent. for- malin solution, or if closed space is available, subjected to formaldehyde gas disinfection, after cushions, hangings, etc., have been removed and washed with the disinfectant. Fig. 111.—Chamber used in government work for formaldehyde disinfec- tion. The small cylinder at the side is the generator. Harness, brushes, combs should be washed with a solution of formalin, carbolic acid, or creolin as given under these topics. Washable articles should be boiled, dropped into disinfectant solutions as soon as soiled, and then boiled or steamed. Unwashable articles—burn all possible. Use formaldehyde gas method in a closed receptacle (Fig. 111). Stock cars—the method described for stables is applicable here. Animals, large and small, may have the coat and surface of the body disinfected by washing with 1 to 1000 bichloride or strong hot soapsuds to which carbolic acid has been added to make a 5 per cent. solution; they should then be given a good warm bath. 156 DISINFECTION AND STERILIZATION Frequently time and money are saved by a combination of steam and formaldehyde disinfection. This is a regular practice in municipal and quarantine disinfection (Fig. 112). Fig. 112.—Chamber in actual use at government quarantine station for disinfecting baggage and dunnage with steam or formaldehyde or both. The small cylinder at the side is the steam formaldehyde generator. Persons engaged in disinfection work should wear rubber boots, coats, and caps which should be washed in a disinfec- tant solution and the change to ordinary clothing made in a special room so that no infective material will be taken away. PART III. THE STUDY OF BACTERIA. CHAPTER XVI. CULTURE MEDJA. Tue study of bacteria may be taken up for the disci- plinary and pedagogic value of the study of a science; with the purely scientific idea of extending the limits of knowl- edge; or for the purpose of learning their beneficial or injurious actions with the object of taking advantage of the former and combating or preventing the latter. Since bacteria are classed as plants, their successful study implies their cultivation on a suitable soil. A growth of bacteria is called a “culture” and the “soil” or material on which they are grown is called a “culture medium.” Insofar as the culture medium is made up in the laboratory it is an “artificial culture medium’’ as distinguished from a natural medium. A culture consisting of one kind of bac- teria only is spoken of as a “pure culture,’ and accurate knowledge of bacteria depends on obtaining them in “pure culture.” After getting a “pure culture” the special charac- teristics of the organism must be ascertained in order to dis- tinguish it from others. The discussion of the morphology of bacteria in Chapters II, III and IV shows that the morphological structures are too few to separate individual kinds. They serve at best to enable groups of similarly appearing forms to be arranged. Hence any further differ- entiation must be based on a study of the physiology of the 158 CULTURE MEDIA organism as discussed in the chapters on Physiological Activities of Bacteria. The thorough study of a bacterium involves, therefore: its isolation in pure culture, its study with the microscope to determine morphological features and special staining reactions; growth on culture media for determining its physiological activities, as well as the morphological charac- teristics of the growths themselves; animal inoculations and special serum reactions. Since isolation in pure culture requires material for growing the organism, the first subject to be considered is culture media. A culture medium for a given bacterium must not only contain the elements necessary for its food, insofar as these may not be derived from the air, but must contain these elements in a form readily available to the bacterium. Further, the medium must not be too dry in order to furnish sufficient moisture for growth and to prevent too high a con- centration of the different ingredients. The reaction must be carefully adjusted to suit the particular organism dealt with. There must be no injurious substances present. The above are the chief points to be borne in mind in preparing culture media. Ordinarily, more attention must be paid to the sources of the two elements N and C than to the others, for in general the substances used to furnish these two and the water contain the other elements in sufficient amount. For very exact work on the products of bacteria, synthetic media containing definite amounts of chemicals of known composition have been prepared, but for most of the work with bacteria pathogenic to animals such media are not needed. Culture media may be either /iguid or solid, or for certain purposes may be liquid at higher temperatures and solid at lower, as indicated later. Liquid media are of value for obtaining bacteria for the study of morphology and cell groupings and for ascertaining many of the physiological activities of the organisms. Solid media are useful for study- ing some few of the physiological activities and especially for determining characteristic appearances of the isolated growths of bacteria, These isolated growths of bacteria on MEAT BROTH 159 solid media are technically spoken of as “colonies,’’ whether they are microscopic in size or visible to the unaided eye. It is clear that the kinds of culture media used for the study of bacteria may be unlimited, but the undergraduate student will need to use a relatively small number, which will be discussed in this section. Meat Broth (Bouillon).'.—This is used as a medium itself, and as the basis for the preparation of other solid and liquid media. Finely ground lean beef is selected because it contains the necessary food materials. Fat is not desired since it is a poor food for most bacteria and in the further processes of preparation would be melted and form an undesirable film on the surface of the medium. The meat is placed in a suitable container and mixed with about twice its weight of cold water (not distilled) and allowed to soak overnight or longer. The cold water extracts from the meat water- soluble proteins, blood, carbohydrates in the form of dextrose (occasionally some glycogen), nitrogenous extractives and some of the mineral salts. The fluid is strained or pressed free from the meat. This “meat juice’ should now be thor- oughly boiled, which results in a coagulation of a large part of the proteins and a precipitation of some of the mineral salts, particularly phosphates of calcium and magnesium, both of which must be filtered off and the water loss restored by adding the proper amount of distilled water. The boil- ing is done at this point because the medium must later be heated to sterilize it and it is best to get rid of the coagulable proteins at once. The proteins thus thrown out deprive the medium of valuable nitrogenous food material which is replaced by adding about 1 per cent. by weight of commercial peptone. It is usual also (though not always necessary) to add about 0.5 per cent. by weight of common salt which helps to restore the proper concentra- tion of mineral ingredients lost by the boiling. The chlorine is also an essential element. The reaction is now deter- 1 The exact laboratory details for preparing various media are not given in this chapter. It is the object to explain the choice of different materials and the reasons for the various processes to which they are subjected. 160 CULTURE MEDIA mined best by titration with twentieth-normal sodium hydroxide solution with phenolphthalein as indicator. The amount of normal alkali or acid as found by titration is now added to the medium to make the desired end reaction (most commonly 1 to 1.5 per cent. acid to phenolphthalein) and the medium is again thoroughly boiled and filtered boiling hot. The titration and boiling ordinarily cause a precipitate to form which is largely phosphates of the alkaline earths with some protein. The filtered medium is collected in suitable containers, flasks or tubes, which are plugged with well- fitting non-absorbent cotton plugs and sterilized, best in the autoclave for twenty minutes at 15 pounds’ pressure, or discon- tinuously in streaming steam at 100°. If careful attention is paid to titration and to sufficient boiling where indicated, the meat broth prepared as above should be clear, only faintly yellowish in color and show no precipitate on cooling. Broth may be prepared from Liebig’s or Armour’s meat extract by adding 5 grams of either, 10 grams peptone and 5 grams NaCl to 1000 c.c. of water, boiling to dissolve, then titrating and filtering as above. The author after much experience finds meat juice prefer- able to meat extract for broth and other media for patho- genic bacteria, and has abandoned the use of meat extracts for these organisms. Glycerin Broth.—Glycerin broth is made by adding 4 to 6 per cent. of glycerin to the broth just previous to the sterilization. The glycerin serves as a source of carbon to certain bacteria which will not grow on the ordinary broth— as Bacterium tuberculosis. Sugar Broths.—Sugar broths are used for determining the action of bacteria on these carbohydrates, since this is a valuable means of differentiating certain forms, especially those from the intestinal tract. Broth free from sugar must first be made. This is done by adding to broth prepared as already described, just previous to final filtering and steriliza- tion, a culture of some sugar-destroying organism (Bacillus colt is ordinarily used), and then allowing the organism to grow in the raw broth at body temperature for twenty-four hours. Any carbohydrate in the broth is destroyed by the GELATIN CULTURE MEDIUM 161 Bacillus coli. This mixture is then boiled to kill the Bacillus colt, retitrated and then 1 per cent. by weight of required sugar is added. Dextrose, saccharose and lactose are the most used, though many others are used for special purposes. After the sugar is added the medium must be sterilized by discontinuous heating at 100° for three or four successive days, because long boiling or heating in the autoclave splits up the di- and polysaccharids into simpler sugars and may even convert the simple sugars (dextrose) into acid. Various other modified broths are frequently used for spe- cial purposes but need not be discussed here. Dunham’s peptone solution, frequently used to determine indol production, is a solution of 1 per cent. of peptone and 0.5 per cent. of salt in tap water. It does not need to be titrated, but should be boiled and filtered hot into tubes or flasks and sterilized. Nitrate Broth.- Nitrate broth for determining nitrate reduction is 1 per cent. of peptone, 0.2 per cent. of C. P. potassium nitrate dissolved in distilled water and sterilized. Milk.—Milk is a natural culture medium much used. It should be fresh and thoroughly skimmed, best by a separator or centrifuge to get rid of the fat. If the milk is not fresh, it should be titrated as for broth and the reaction adjusted to 0.8 per cent. acid. The milk should be sterilized discon- tinuously to avoid splitting up the lactose as well as action on the casein and calcium phosphate. Litmus Milk—Litmus milk is milk as above to which litmus has been added as an acid production indicator. The milk should show blue when the litmus is added or be made to by the addition of normal NaOH solution. It should be sterilized discontinuously. Frequently on heating litmus milk the blue color. disappears due to a reduction of the litmus. This blue color will reappear on shaking with air or on standing several days, due to absorption of O and oxidation of the reduced litmus, provided the heating has produced no other change in the milk, as proper heating will not. Gelatin Culture Medium.—Gelatin to the extent of 10 to 15 pes cent. is frequently added to broth and gives a culture 1 162 CULTURE MEDIA medium of many advantages. It is solid at temperatures up to about 25° and fluid above this temperature, a property which is of great advantage in the isolation of bacteria. (See Chapter XVIII.) Further gelatin is liquefied (that is digested, converted into gelatin proteose and gelatin pep- tone, which are soluble in water and do not gelatinize) by many bacteria and not by others, a valuable diagnostic fea- ture. The gelatin colonies of many bacteria are very charac- teristic in appearance, as is the growth of many on gelatin in culture tubes. Gelatin medium may be prepared by adding the proper: amount of gelatin (10 to 15 per cent. by weight) broken into small pieces, to broth, gently warming until the gelatin is dissolved, standardizing as for broth, filtering and sterilizing. It is usually cleared before filtering by stirring into the gela- tin solution, cooled to below 60°, the white of an egg for each 1000 c.c., and then thoroughly boiling before filtering. The coagulation of the egg albumen entangles the suspended matter so that the gelatin filters perfectly clear, though with a slight yellowish color. The filtering may be done through filter paper if the gelatin is well boiled and filtered boiling hot, but is more conveniently done through absorbent cotton, wet with boiling water. Or, the gelatin may be added to meat juice before it is bowled, then this is heated to about body temperature (not too hot, or the proteins will be coagulated too soon) until the gelatin is dissolved. Then the material is standardized and thoroughly boiled and filtered. The proteins of the meat juice coagulate and thus clear the medium without the addition of egg white. Commercial gelatin is markedly acid from the method of manufacture, hence the medium requires careful titration, even when made from a standard- ized broth. Gelatin should be sterilized by discontinuous heating at 100° on three successive days, because long boiling or heat- ing above 100° tends to hydrolyze the gelatin into gelatin pro- teose and peptone and it will not gelatinize on cooling. It may be heated in the autoclave for ten to fifteen minutes at 10 pounds’ pressure and sometimes not be hydrolyzed, but AGAR MEDIUM 163 the procedure is uncertain and very resistant spores may not be killed. The medium should be put into the culture tubes in which it is to be used as soon as filtered, and sterilized in these, since, if put into flasks these must be sterilized, and then when transferred to tubes for use, it must be again sterilized unless great care is taken to have the tubes plugged -and sterilized first, and in transferring aseptically to these tubes. These repeated heatings are very apt to decompose the gelatin, so it will not “set”? on cooling. The prepared and sterilized tubes of gelatin should be kept in an ice-box or cool room, as they will melt in overheated laboratories in summer or winter. Agar Medium.—Agar agar, usually called agar, is a com- plex carbohydrate substance of unknown composition ob- tained from certain seaweeds along the coast of Japan and Southeastern Asia. It occurs in commerce as thin translucent strips or as a powder. It resembles gelatin only in the property its solutions have of gelatinizing when cooled. Gelatin is an albuminoid closely related to the proteins, agar a carbohydrate. Agar is much less soluble in water, 1 or 1.5 per cent. of agar giving a jelly as dense as 10 to 15 per cent. of gelatin. It dissolves only in water heated to near the boiling-point (98° to 99°) and only after much longer heating. This hot solution “jells,” “sets” or gelatinizes at about 38° and remains solid until again heated to near boil- ing. Hence bacteria may be grown on agar at the body temperature (37°) and above, and the agar will remain solid, while gelatin media are fluid above about 25°. No patho- genic bacteria and none of the saprophytes liable to be met with in the laboratory are able to “liquefy”’ agar. An agar medium is conveniently prepared from broth by adding 1 or 1.5 per cent. of the finely divided agar to the broth and boiling until dissolved, standardizing, clearing, filtering, and sterilizing. The agar must be thoroughly boiled, usually for ten to fifteen minutes, and the water loss made up by the addition of distilled water before titration. Agar is practically neutral so that there is little difference between the titration of the dissolved agar and the original broth. The agar solution should be kept hot from the begin- 164 CULTURE MEDIA ning to the end except the cooling down to below 60°, when the egg white for clearing is added. Though filtration through paper is possible as with gelatin, if the agar solution is thoroughly boiled and filtered boiling hot, it is more satis- factory for beginners to use absorbent cotton wet with boil- ing water, and to pour the hot agar through the same filter if not clear the first time. The solidified agar medium is never perfectly clear, but always more or less opalescent. The agar medium may be sterilized in the autoclave for fifteen minutes at 15 pounds’ pressure as the high temperature does not injure the agar. Potato Media.—Potatoes furnish a natural culture medium which is very useful for the study of many bacteria. The simplest, and for most purposes the best, way to use potatoes is in culture tubes as “potato tube cultures” (No. 8, Fig. 117). These are prepared as follows: Large tubes are used. With a cork-borer of a size to fit the tubes used, cylinders about one and one-half inches long are cut from fairly large, healthy potatoes. The skin is cut off square from the ends and each cylinder cut diagonally from base to base. This furnishes two pieces each with a circular base and an oval, sloping surface. The pieces are then washed clean and dropped for a minute into boiling water to destroy the oxi- dizing enzyme on the surface which would otherwise cause a darkening of the potato. (The darkening may also be prevented by keeping the freshly cut potatoes covered with clean water until ready to sterilize.) A bit of cotton one- fourth to one-half inch in depth is put into each of the test-tubes to retain moisture and a piece of potato dropped in, circular base down. The tubes are then plugged with cotton and sterilized in the autoclave at 15 pounds’ pressure for not less than twenty-five minutes, since potatoes usually harbor very resistant spores, and it is not unusual for a few tubes to spoil even after this thorough heating. Potatoes are sometimes used in “potato plate cultures.” The term “plate culture” is a relic of the time when flat glass plates were used for this and other “plate cultures.” Now glass dishes of the general form shown in Fig. 113, called ‘Petri dishes,” or plates are used for practically all POTATO MEDIA 165 plate culture work. For “potato plates” slices from pota- toes are cut as large and as thick as the relative sizes of potato and dish permit (Fig. 114). The slices should be thin enough not to touch the lid and thick enough to be firm. Fic. 113.—Petri dish with the lid partly raised. X 4. Fic. 114.—A potato plate. x 4. It is a good plan to wrap each dish separately in paper to retain the lid securely, then sterilize as for potato tubes, and leave plates wrapped until wanted. It sometimes happens that the natural acidity of potatoes 166 CULTURE MEDIA is too great for the growth of many organisms. The acidity is sufficiently corrected by saaking the pieces of potato in a 1 per cent. solution of sodium carbonate for an hour before they are put into the tubes or plates. Glycerinized potato tubes are conveniently prepared by covering the potato in the tube with glycerin broth, steril- izing and pouring off the excess broth immediately after sterilizing, taking care that the tubes do not become con- taminated which is not very probable if the work is quickly done while the tubes are still hot. Blood Serum Media.—Blood serum, usually from the larger, domestic animals on account of convenience in securing it in quantity, is used in the study of the bacteria causing disease in man and animals. Most commonly the serum is collected from the clotted blood after it has well separated (usually about forty-eight hours is required for this). It is then run into tubes which are plugged with cotton and placed in an an apparatus for coagulating the serum by heat. A copper * water bath with a tightly closed air compartment or the hori- zontal autoclave (Fig. 80) is sufficient for this purpose, though special forms of apparatus are to be had. It is important that the temperature be raised slowly so that the blood gases escape gradually. Three to five hours or longer should be allowed for the temperature to reach the boiling-point. If the tubes are heated too rapidly, the serum is filled with bubbles and badly torn since the gases are driven off suddenly. Léffler’s serum is made by adding one part of dextrose broth to three parts of serum and then coagulating as above. The solid- ified serum in either case is best sterilized discontinuously, though with care the autoclave at 15 pounds’ pressure may be used for a single sterilization. This is very apt to cause a greater darkening of the serum and frequently also a laceration of the solid mass by escaping gases. Blood serum is also used in the liquid state. For this purpose it is best to collect it aseptically; or it may be sterilized discontinuously at a temperature of 55° or 56° on seven to ten consecutive days. Novy has recently suggested dialyzing the serum to free it from salts and thus prevent its coagulation when heated. Whether the removal of the BLOOD SERUM MEDIA 167 various “extractives” which diffuse out with the salts deprives the serum of any of its advantageous properties remains to be ascertained. From the discussion of the physiological activities of bac- teria in Chapters IX—XII it is apparent that a very great variety of culture media other than those described is neces- sary for the study of special types of bacteria, but such media are beyond the scope of the present work. The ideal culture media are without a doubt the synthetic media, that is, media of definite known chemical composition, so that the various changes due to the growth of bacteria can be accurately determined and thus a means of sharply differentiating closely related organisms be secured. Such media have been prepared and every bacteriologist believes strongly in their future usefulness when media of wider application shall have been devised. An example of this type of culture media is Uschinsky’s synthetic medium, of which the following is one of the modifications: Distilled water “ : 1000 parts Asparagin. . ‘ tig 4 “ Ammonium lactate ‘ 6 “ Disodium phosphate . 2 a Sodium chloride . ; 5. A criticism of this medium is that the elements K, Ca, Mg, Fe, Mn, and S which have been shown to be essential are not present if chemically pure salts are used in the preparation. CHAPTER XVII. METHODS OF USING CULTURE MEDIA. THE way in which culture media shall be used depends on the purpose in view. By far the larger part of bacterio- logical work is done with cultures in “bacteriological cul- ture tubes.” Various laboratories have their own special types but all are more or less after the “Board of Health” form. They differ from ordinary chemical test-tubes in that they are usually longer, have no “lip” and have much thicker walls to prevent breakage and consequent loss of the cul- ture as well as danger from pathogenic organisms. The author finds two sets of tubes most serviceable for student use—one size 15 cm. long by 19 mm. outside diameter (No. 9, Fig. 117), the other 15 em. long by 13 mm. (Nos. 1 to 7, Fig. 117). Culture tubes are conveniently used in “wire baskets” circular or square in section and of a size to correspond with the length and number of tubes used. These baskets are light, do not break, and if made of good galvanized wire netting do not readily rust (Figs. 115 and 116). Liquid media such as broth, milk, litmus milk, indol and nitrate broths are used in the above-mentioned tubes when small quantities only are to be worked with. The tubes are filled approximately one-third full, then plugged with non-absorbent cotton and sterilized. Cotton plugs are used so much in bacteriological work because they permit a free circulation of air and gases and at the same time act as filters to keep out the bacteria of the air. Sugar broths or other media in which gas may be produced are used in fermentation tubes (Smith’ tubes) of the type shown in Fig..118 so that the gas may be collected in the closed arm of the tube, measured (Fig. 119) and tested if desired. METHODS OF USING CULTURE MEDIA 169 One method of using gelatin and also agar is as “ puncture” or “stab” cultures. The tubes (the narrower tubes are to be 4 oa MS, Tune Nite Ne 7) mo ay es at Ce ce os ‘ SASS Fig. 115.—Round wire basket. Fie. 116.—Square wire basket. Fig. 117.—Culture tubes with media in them. x 4. J to 7 are the smaller tubes mentioned in the text; 9 the larger tube; 8 is extra large for potato tubes; 1, plain broth; 2, plain milk; 3, litmus milk; 4, gelatin for “stab” or ‘“‘puncture” culture; 5, agar for ‘‘stab” or ‘‘puncture” culture; 6, agar for ‘‘slope’’ or ‘‘slant’’ culture; 7, blood serum; 8, potato tube; 9, agar for plating. Note the transparency of the broth and gelatin and the slight opalescence of the agar. 170 © METHODS OF USING CULTURE MEDIA preferred for most “stab” cultures) are filled one-third full of the medium while it is still fluid, plugged, sterilized and allowed to cool in the vertical position. The medium is then “inoculated” with a straight platinum needle by plunging this into the center of the surface down to the bottom of the tube (Fig. 117, Nos. 4 and 5). Fic. 118.—Fermentation tubes. 1, filled ready for use; 2, shows a cloudy growth and the development of gas in the closed arm. Agar and blood serum are frequently used in the form of “slope” or “slant” cultures. That is, the medium solidifies with the tubes lying on their sides which gives a long, sloping surface on which the bacteria are inoculated (Fig. 117, Nos. 6 and 7). Potato tubes are likewise used for “slant” or “slope” cultures (Fig. 117, No. 8). Potatoes as “plate cultures” have been referred to. Agar and gelatin are very largely METHODS OF USING CULTURE MEDIA 171 Fie. 119.—Method of estimating percentage of gas in a fermentation tube by means of the ‘‘gasometer.’’ The reading is 45 per cent. Fic. 120.—A toxin flask showing a large surface growth. 172 METHODS OF USING CULTURE MEDIA used in the form of “plate cultures” also. For this purpose Petri dishes are first sterilized, then the melted agar or gelatin poured in to them and allowed to “set” while the plates are kept horizontal. The melted media may be “inoculated” before they are poured, or a portion of the material to be “plated” may be placed in the dish, then the melted medium poured in and distributed over the dish by tilting in various directions, or the medium after solidify- ing may be inoculated by “strokes” or “streaks” over its surface, according to the purpose in view in using the plate. The larger sized tubes should be used for making plates in order to have sufficient medium in the plate (No. 9, Fig. 117). For using large quantities of medium, Florence flasks, Ehrlenmeyer flasks, special toxin flasks (Fig. 120) or various other devices (Vaughan and Novy’s “mass cultures,” Figs. 121 and 122) have been employed. For growing anaérobic organisms it is evident that some method for removing and excluding the.oxygen of the air must be used. A very great variety of appliances have been devised for these purposes. Some are based on the principle of the vacuum, exhausting the air with an air pump; some on replacing the air with a stream of hydrogen; others on absorbing the oxygen by chemical means, as with an alkaline solution of pyrogallic acid, or even by growing a vigorous aérobe in the same culture or in the same con- tainer with the anaérobe, the aérobe exhausting the oxygen so that the anaérobe then develops, or finally by excluding the air through the use of deep culture tubes well filled with the medium, or in the closed arm of fermentation tubes. For many purposes a combination of two or more of the above methods gives good results. In any event the culture medium should have been freshly sterilized just before use, or should be boiled in order to drive out the dissolved oxygen. For most anaérobes the presence in the medium of about 1 per cent. of a carbohydrate, as dextrose, is advisable. A description of all the various devices is unnecessary in this work, but the following have answered most of the purposes of general work in the author’s laboratories. METHODS OF USING CULTURE MEDIA 173 cl. “Vignal tubes” of the style shown (Fig. 123) are made from glass tubes of about 6 to 8 mm. outside diameter, Fig. 121.—Tank with raised lids. (Vaughan.) LAs fA UA EAPC ROOT ; Fic. 122.—Tank with lids lowered. (Vaughan.) Figs. 121 and 122.—Vaughan and Novy’s mass culture apparatus. 174 METHODS OF USING CULTURE MEDIA sealed at the small end, plugged with cotton above the constriction and sterilized. The medium, agar or gelatin, which has been previously inoculated with the anaérobic culture, is then drawn up into the tube, after breaking off the tip, as far as the constriction. The tube is then sealed in the flame at the small end and also at the constriction. Since it is full of the medium and sealed, access of air is prevented. This forms an excellent means for “isolation” (Chapter XVIII); the tube needs merely to be cut with a file at the point where colonies appear, then these may be readily transferred. Fic. 123.—Vignal tubes. xX 4. 1, the sterile tube ready for inoculation; 2, fourth dilution tube showing a few isolated colonies, one near the figure; 3, third dilution tube showing colonies isolated but numerous; 4, second dilution tube showing colonies still more numerous; 4, first dilution tube showing colonies so numerous and small as to give a cloudy appearance to the tube. In use tube 2 would be filed in two at the colony and inoculations made from it. B. “Fermentation tubes” form a simple means for growing liquid cultures of anaérobes, the growth occurring in the closed arm only, while with facultative anaérobes, growth occurs both in the closed arm and in the open bulb. A little “paraffin oil” (a clear, heavy petroleum derivative) may be poured on the fluid in the open bulb as a very efficient seal, though it is not usually necessary. C. “Deep culture tubes.”—The medium, agar, gelatin or a liquid, is poured into tubes until they are approximately one-half full, a little paraffin oil is poured on the surface (not essential always), then the tubes are plugged and steril- METHODS OF USING CULTURE MEDIA 175 ‘ized. Inoculation is made to the bottom and anaérobes grow well (Fig. 124). D. For slope or plate, or any type of surface cultures the Novy jar (Fig. 125) is the most practical device. It is good wr x Fic. 124.—Deep tubes showing anaérobic growth. 1, shows a few small gas bubbles; 2, shows the medium broken up by the excessive development of gas. practice to combine the vacuum method, the hydrogen replacement method and the oxygen absorption method in using these jars. In operation a solution of 20 per cent. .NaOH is poured on the bottom of the jar to a depth of 1 or 2 cm., the cultures are placed on glass supports | above the alkali and a short wide tube of strong pyrogallol is set in on the bottom in such a way that it may be easily 176 METHODS OF USING CULTURE MEDIA upset and mixed with the alkali when it is desired to do so. The cover is now clamped in position with ‘all joints well vaselined. Then the outlet tube is connected with a suc- tion pump and the air drawn out. Meanwhile the inlet tube has been connected with a hydrogen generator, and after the jar is exhausted hydrogen is allowed to flow in, and this process is repeated until one is satisfied that the air is replaced. The suction exhausts the air from the tubes or plates so that much less time is required to replace the air with hydrogen. Finally, the stop-cock is closed, and the pyrogallol solution is gently shaken down and mixed with the alkali so that any remaining oxygen will be absorbed. = Fic. 125.—Novy jars. It must be remembered that facultative anaérobes as well as anaérobes will grow under any of the above conditions, so that cultures of organisms so obtained must be further tested aérobically in order to determine to which group the organisms belong. Reference has been made above to the “inoculation” of culture media, which means introducing into the medium used the desired material in the proper way. For small quantities this is most conveniently done with platinum “needles,” that is, pieces of platinum wire inserted into the ends of glass rods. The “straight” needle is a piece of heavy platinum wire of about 0.022 inch in diameter (Fig. 126). It is used most frequently to inoculate all forms of solid METHODS OF USING CULTURE MEDIA 177 media. The platinum loop is of lighter wire, 0.018 inch. The loop in the end is conveniently made by twisting the wire around the lead of an ordinary lead-pencil. The “loop needle” (Fig. 127) is most used in transferring liquid media. On account of the high price of platinum, the author has substituted “nichrome” wire for student use. This is stiffer, not so easily made into loops and breaks out of the rods more easily. The latter defect is remedied to some extent by imbedding the wire only slightly for about one-fourth Fic. 126.—Straight needle. rt) >————————SSEEE | Fic. 127.—Straight and loop needles. Fig. 128.—Pasteur flask—‘'‘ ballon pipette.” of an inch on the side of the end portion of the rod. The low cost, less than one-twentieth of platinum, justifies its use. Sterile graduated pipettes varying in capacity from 1 c.c., graduated in hundredths, upward, permit the transfer of definite amounts of liquids. Large quantities are conven- iently transferred by means of Pasteur flasks (Fig. 128). The details of inoculation are best derived from laboratory practice. 12 CHAPTER XVIII. ISOLATION OF BACTERIA IN PURE CULTURE. As has been stated, the thorough study of a bacterium depends on first getting it in pure culture. In the early days of bacteriology supposedly pure cultures were obtained by (1) dilution in liquid media. A series of tubes or flasks containing sterile liquid media was prepared. Number one was inoculated with the material to be examined and thor- oughly mixed. A small portion of the mixture was trans- ferred to number two, and mixed; from this to number three, and so on until a sufficient number were inoculated, the last three or four in the series receiving the same amounts of a very high dilution of the original material. If one or two of these latter showed a growth and the others not, it was assumed that the dilution had been carried so far that only a single organism was transferred and therefore the culture obtained was “pure.” The method in this crude form is too uncertain to be of value today and recourse is had to more exact means. The procedure most widely used is that of (2) “plating out” by means of gelatin or agar plates. The material to be plated out is diluted by trans- ferring to three or more tubes of melted gelatin or agar as in the first method and then all the tubes are poured into Petri dishes and grown under suitable conditions. By proper mixing in the tubes the bacteria are well scattered through the medium which holds the individual organisms separate when it solidifies. On some of the plates a suffi- cient dilution will be reached so that the colonies develop- ing from the bacteria will be so few that they are separate and pure cultures may be obtained by inoculating from one of these a tube of the appropriate medium (Figs. 129 to 182). The chief uncertainty with this method is that occasionally two kinds of bacteria stick together so closely ISOLATION OF BACTERIA IN PURE CULTURE 179 that even the separate colonies contain both organisms. This is not common, however. The plate colonies frequently Fic. 129.—Dilution plates. 3%5. 1, shows the first dilution, the colo- nies are so numerous and small that they are invisible (compare Fig. 130); 2, shows fewer and hence larger colonies, but too crowded to isolate (compare Fig. 131); 3, shows the colonies, larger and well separated, so that it ‘is easy to isolate from them (compare Fig. 132). develop from groups of bacteria which were not separated, but as these are of the same kind the culture is essentially pure. Fig. 130.—A portion of plate 1 in Fig. 129 as seen under the low-power objective. X 100. Very small, closely crowded colonies. Another method which is frequently applicable with material from human or animal sources is to (3) rub the material over the surface of a slope tube or of medium solid- ified in a Petri dish with a sterile heavy platinum needle, 180 ISOLATION OF BACTERIA IN PURE CULTURE glass rod, ‘or cotton swab. If the bacteria are not too numer- ous, pure cultures may frequently be obtained. A modifi- cation of this method is to make a series of (4) parallel streaks on a slope tube or plate of medium with a needle inserted but once into the material to be plated. On the first streak a large part of the bacteria are rubbed off and a continuous growth results, but usually on the last of a series only isolated colonies appear, which are presumably pure. The ideal method for securing pure cultures is to be abso- lutely certain that the culture starts from a single organism. So Fig. 181.—From the thinnest part Fic. 132.—The smallest colony of plate 2, Fig. 129,asseenunder the on plate 3, Fig. 129, as seen under low-power objective. 100. Colo- the low-power objective. x 100. nies much larger than on plate 1, Large single, isolated colony. but still crowded. This may be accomplished by means of the (5) apparatus and pipettes devised by Professor Barber of the University of Kansas (Figs. 133 and 134). With this instrument a single organism is picked out under the microscope and isolated in a drop of culture medium and observed until it is seen to divide, thus proving its viability. Transfers are then made to the proper media. The method requires much practice to develop the necessary skill in the making of pipettes, determining the proper condition of the large cover-glasses used over the isolating box, and in manipulation, but the results fully compensate, ISOLATION OF BACTERIA IN PURE CULTURE 181 Professor W. A. Starin of the author’s department, a former student of Professor Barber, has done some excellent work with this apparatus. Fic. 133.—Diagram of Barber's isolation apparatus. 6, moist chamber; ms, large cover-glass over moist chamber; 7, small pipette drawn out to a fine point; k, r, g, pipette holder; f, screw for raising and lowering k, r, g; s, ; screw for lateral motion of k,r, g; n, screw for clamp on pipette which allows it to be moved in or out; m, mechanical stage of microscope; t, rubber tube ‘held in the mouth and used to move the liquid culture medium in the pipette. (Journal of Infectious Diseases, October 20, 1908, vol. 5, No.4, p.381.) 182 ISOLATION OF BACTERIA IN PURE CULTURE A number of procedures may be used to greatly facilitate the above methods of isolation by taking advantage of the different physiological properties of different organisms in a mixture, such as ability to form spores, different resistance to antiseptics, special food requirements, and pathogenic Fic. 134.—Photograph of microscope with Barber’s isolation apparatus set up to use. properties. (a) If material contains resistant spores, it may be heated to temperatures high enough to kill all of the organ- isms except the spores (80° for half an hour, for example) and then plated out. Or (b) an antiseptic which restrains the growth of some organisms and not others may be placed ISOLATION OF BACTERIA IN PURE CULTURE 183 in the culture media (carbolic acid, various anilin dyes, excess acid, or alkali, ox bile, etc.), when the more resistant organisms grow on the final plates, the others not. (c) Special food substances (various carbohydrates) from which the organism desired forms special products (acids, alde- hydes) that may be shown on the plates by various indica- tors, is one of the commonest means. Or media in which certain organisms thrive and others not, so that the former soon “crowd out” the latter (unsterilized milk for lactic acid bacteria, inorganic media in soil bacteriology), may be used. A combination of the general methods (b) and (c) is much used in the separation of the organisms of the “intestinal group” in human practice. (d) The inoculation of a susceptible ani- mal with a mixture suspected to contain a given pathogenic bacterium frequently results in the development of the latter in pure culture in the body of an animal, from which it may be readily recovered. In all of the above methods (except Barber’s) the first “pure culture’? obtained should be “ purified” by replating in a series of dilution plates to make sure that it is pure. CHAPTER XIX. STUDY OF INDIVIDUAL BACTERIA-STAINING. WHEN an organism has been obtained in pure culture by any of the methods described in the preceding chapter the next step is the study of its morphology as discussed in Chapters I-IV. This involves the use of the microscope, and since bacteria are so small, objectives of higher power than the student has presumably used will be needed. Doubtless only the two-third inch or 16 mm. and the one- sixth inch or 4 mm. objectives are all that have been used in previous microscopic work, while for examining bacteria a one-twelfth inch or 2 mm. is necessary. It will have been observed that the higher the power of the objective the smaller is the front lens or object glass and consequently the less is the amount of light which enters. With the use of the one-twelfth inch or 2 mm. objective it is necessary to employ two devices for increasing the amount of light enter- ing it, with which the student is probably not familiar. One of these is to place a drop of cedar oil between the front jens and the object and to immerse the lens in this oil— hence the term ‘‘oil-immersion objective; the other is the substage or Abbé condenser. The latter is a system of lenses placed below the stage and so constructed as to bring parallel rays of light—daylight—trom an area much larger than the face of the front lens of the objective to a focus on the object to be examined, thus adding very greatly to the amount of light entering the objective. Since the con- denser brings parallel rays to a focus on the object the flat- mirror 1s always used with the condenser when working with daylight. With artificial light close to the microscope, the concave mirror may be used to make the divergent rays more nearly parallel and thus give better illumination. The function of immersion oil is to prevent the dispersion HANGING DROP SLIDE 185 of considerable light that would otherwise occur owing to refraction as the light passes up through the slide and into the air. The accompanying diagram will help to make this clearer (Fig. 135). A ray of light (.f. B) coming through the slide will be refracted in the direction B C if the medium has a lower refractive index than the slide, as air has, and hence will not enter the objective O. If, however, there is interposed between the objective and the slide a medium which has the same refractive index as the slide, as immer- sion oil has, then the ray will continue in the same direction (B D) at the point B and hence enter the objective. Evi- ront lens of objective Immersion oil a \ Slide i Fig. 135.—Diagram of use of immersion oil. { dently the immersion oil causes much more light to enter the front lens and makes the field brighter and at the same time prevents considerable refraction and dispersion of light from the object seen and hence this appears more distinct and sharply defined. The Abbé condenser and the oil- immersion objective are practically always used in the microscopic study of bacteria (Fig. 136). HANGING DROP SLIDE. It is sometimes necessary to examine living bacteria and for this purpose the device known as the “hanging drop Fig. 136.— Diagram of paths of rays in microscope. HANGING DROP SLIDE 187 slide” is used (Fig. 137). The slide has a slight concave depression ground in the middle of one face. A ring of vaseline is placed around this depression with the loop needle. On a clean cover-glass, large enough to fit over the ring of vaseline, several drops of a broth culture, or of material from a solid culture suspended in broth or physiological normal salt solution are placed. The slide is inverted on the cover-glass in such a way that the ring of vaseline seals the latter to the slide. When the whole preparation is quickly turned cover side up, the drops are seen “hanging”’ to the under side of the cover over the depression in the slide. In examining such a preparation with the micro- scope great care is necessary in order to focus on the bac- teria without breaking the cover. To see the organisms distinctly the lower iris diaphragm of the condenser must be nearly closed, so that the light coming through consists mainly Cc SS | Fic. 137.—Hanging drop slide. of parallel vertical rays, otherwise the transparent bacteria themselves refract and diffract the light and appear blurréd and indistinct. By studying living bacteria with this device it can be determined whether they are motile or not. The motility should not be confounded with the familiar “ Brown- ian movement” of all minute insoluble inert particles which non-motile living bacteria and also dead bacteria show. The hanging drop slide is of value in the measurement of bacteria, since this is properly done on the living organism. Measurement is done with a calibrated ocular micrometer as in other kinds of measurement with the microscope with which the student is presumably familiar. The direct effect of various agents on living bacteria as light, electricity, heat, etc., in the study of “tropisms” and “taxes” has been investigated on various modifications of the above-described hanging drop slide. Cell forms and cell groupings may be studied in the same 188 STUDY OF INDIVIDUAL BACTERIA-STAINING way but these features are best determined on starned preparations. “Dark field” illumination and the ultramicroscope are of great value in the study of living bacteria and other minute objects, but apparatus of this type would scarcely be used by the elementary student, so that they will not be discussed in the present volume. STAINING. The main use of the microscope in bacteriology is in the study of stained preparations of the organisms. Staining makes bacteria opaque and hence more easily seen than the transparent unstained forms. Some methods of staining also show morphological structures which are either imperfectly recognized in the unstained cell, spores, or are not visible at all—capsules, metachromatic granules, flagella. Finally certain bacteria are colored by special methods of staining which do not affect others, so that under proper conditions these bacteria may be recognized by staining methods alone, —tubercle bacilli in the organs of animals. The phenomena of staining are essentially chemical, though sometimes the chemical union is a very weak one, even resembling an adsorption of the dye rather than true chemical union—most watery stains. In other cases the chemical compounds formed are decidedly stable and are not decomposed even by strong mineral acids—staining of tubercle bacilli and other “acid-fast” organisms. In still other cases the principal action is a precipitation on the surface of the object stained—methods for staining flagella. In many methods of staining in addition to the dves used other substances are added to the solution which assist in fixing the dye in or on the organism stained. Such substances are called mordants. The principal mordants used are alka- lies, anilin, carbolic acid, iodine, metallic salts, tannic acid. While it is true that some bacteria may be stained by that standard histological nuclear dye, hematoxylin, it is of little value for this purpose. Practically all bacteriological stains are solutions of the anilin dyes. These dyes, as is well STAINING 189 known, are of nearly every conceivable color and shade but relatively very few are used in bacteriological work. The elementary student will rarely use solutions of other than the three dyes fuchsin (red), methylene blue and gentian volet for staining bacteria, with occasionally Bismarck brown, or eosin, or safranin as tissue contrast stains. The bacteriological dyes are kept “in stock” as saturated solutions in 95 per cent. alcohol which are never used as stains, but merely for convenience in making the various staining solutions of which the following are the most common: 1, Aqueous (watery) gentian violet solution. Saturated alcoholic solution of gentian violet Sree 3 a 1 part Distilled water . 20 parts Mix well and filter. 2. Anilin gentian violet. Saturated alcoholic solution of gentian violet é 1 part Anilin water (see below) ; . 10 parts Mix well and filter. 3. Anilin Fuchsin. Saturated alcoholic solution of fuchsin Bon 1 part Anilin water (see below) . . 10 parts Mix and filter. These stains rarely keep longer than ten days in the laboratory (unless kept in the ice-box) and must be made fresh on the first sign of a deposit on the glass of the container. Anilin Water.—Anilin water is made by putting 3 or 4 e.c. of anilin “oil” in a 120 c.c. flask, adding 100 c.c. of distilled water, shaking vigorously for a minute or so and filtering through a wet filter, in other words, a saturated solution of anilin in water. 4, Loffler’s (methylene) blue. Saturated alcoholic solution of methylene blue . 3 parts Aqueous solution of NaOH (or KOH), 1 to 10,000 . . 10 parts Mix and filter. 5. Carbol-fuchsin (Ziehl’s solution). Saturated alcoholic solution of fuchsin. 1 part 5 per cent. aqueous solution of carbolic acid ane 10 parts Mix and filter. 190 STUDY OF INDIVIDUAL BACTERIA-STAINING 6. Gabbet’s (methylene) blue (solution). Dry methylene blue 2 ‘ 4 parts Concentrated H.SO,. . “ 25 parts Distilled water . . . 75 parts Dissolve the dry dye in the ‘acid and add the solution to the dis- tilled water and filter. Staining solutions are conveniently kept in square drop- ping bottles inserted in a block as shown in Fig. 138. This form of holder necessitates the use of one hand only in secur- ing the stain and dropping it on the preparation. LUEAM LOEFFLERS SOLUTION L3U gs Fig. 138.—Author’s staining set. Square bottles are set in square holes in the block. The capacity of each bottle is 30 c.c. The actual staining of bacteriological preparations can be learned only by repeated laboratory practice, yet the following methods have given such uniform results in class work that it is felt they are not out of place in a text-book. Preparation of the “Film.’—The author learned to stain bacteria on the “cover-glass’’ but does not recall having used this method in fifteen years and does not teach it to his students. All staining is done on the slide. To prepare a film from a solid culture medium the procedure is as follows: STAINING 191 First, be sure the slide is clean and free from grease. This is accomplished most readily by scouring a few minutes with finely ground pumice stone and a little water, then washing and drying with a grease-free cloth, handkerchief, or piece of cheese-cloth, With the “loop’’ needle place in the middle of the slide a small loop of water. This is best done by filling the loop by dipping in water, then tapping it gently so that all that remains is the water that just fills the loop level full, and this amount is placed on the slide by touching the flat side of the loop to the glass. Then the straight needle is sterilized, dipped into the culture and just touched once into the small drop of water on the slide. The remain- der of the culture on the straight needle is then burned off and the needle is used to spread the drop of water contain- ing the bacteria into a thin even film, which will result, pro- vided the slide is free from grease. This is dried and then “fixed” by passing three times through the Bunsen flame at intervals of about one second, passing through slowly for thick slides and a little more rapidly for thin ones. If the culture is in a liquid medium, the use of the loop of water is unnecessary; a loop of the fluid from the surface, middle or bottom as the culture indicates is spread out to a thin film, dried and fixed. After the film is fixed the stain desired is dropped on, allowed to act for the proper time, which will depend on the stain and the preparation, washed in water, dried thor- oughly and examined with the oil-immersion lens, without a cover. If it is desired to preserve the preparation it may then be mounted in balsam. This is not necessary, as they keep just as well, provided the immersion oil is removed. To do this, fold a piece of filter paper so that at least three thicknesses result. Lay this on the slide and press firmly several times, when the surplus oil will be taken up by the paper. Slides not mounted in balsam are more apt to become dusty than those that are. This is the only disad- vantage. : Gram’s Method of Staining.—It has been ascertained that some bacteria contain a substance, possibly a protein, which forms a compound with gentian violet and iodine, which 192. STUDY OF INDIVIDUAL -BACTERIA-STAINING compound is insoluble in alcohol, and other bacteria do not contain this substance. Consequently when bacteria are stained by Gram’s method (given below), those that con- tain this chemical remain colored, while if it is not present the dye is washed out by the alcohol and the bacteria are colorless and may be stained by a contrast stain. The bac- teria which stain by this method are said to “take Gram’s” or to be ‘Gram-positive,’ while those that decolorize are called “ Gram-negative.’”” The method is: . Prepare the film as above given. . Stain with fresh anilin gentian violet 1 minute. . Wash in tap water. . Cover with Gram’s solution (1 minute). . Wash in tap water. . Wash with 95 per cent. alcohol three times or until no more color comes out. 7. Dry and examine. Gram’s solution is: Oorkwwere I 1 part KI. 2 parts H:.0 i 300 parts This method is excellent for differentiating Gram-posi- tive and Gram-negative organisms on the same slide. First stain by this method and after washing with alcohol stain with a counter-stain, carbol-fuchsin diluted ten to fifteen times with water is excellent. The Gram-positive bacteria are violet and the Gram-negative are red. It is also of great value in staining Gram-positive bac- teria in tissues, but the sections should be stained about five minutes in the anilin gentian violet and be left about two minutes in the Gram solution. Sections are to be counter- stained in Bismarck brown, dilute eosin or safranin solutions and cleared in oil of bergamot, lavender or origanum and not in clove oil or carbol-xylol, as these latter dissolve out the dye from the bacteria. Staining of Spores in the Rod.—Prepare the films as usual. Cover with carbol-fuchsin, using plenty of stain so that it will not dry on the slide; heat until vapor arises, not to boil- ing; cool until the stain becomes cloudy and heat again STAINING 193 until the stain clears, and repeat once more; wash in tap water and then wash in 1 per cent. H,SO, three times, dropping on plenty of acid, tilting and running this over the slide three times and then pour off and use fresh acid and repeat this once. Wash thoroughly in distilled water, then stain with Léffler’s blue one to three minutes. Wash, dry and examine. The spores should be bright red in a blue rod. This method will give good results if care is taken to secure cultures of the right age. If the culture is too old the spores will all be free outside the rods, while if too young they will decolorize with the acid. For Bacillus subtilis and Bactervum anthracis, cultures on agar slants forty-eight hours in the 37° incubator are just right. For the spores of Bacillus tetant, the culture should be three days old, but may be as old as a week. Staining of ‘“‘Acid-fast’ Bacilli— Bacterium tuberculosis, Bacterium of Johne’s disease, “ grass’? and “butter bacilli,” Bacterium lepre, Bacterium smegmatis. Gabbet’s method: . Prepare the film as usual. . Stain with carbol-fuchsin as given above for spores. . Wash with tap water. . Decolorize and stain at the same time with Gabbet’s blue, 2 or 3 minutes. . Wash, dry and examine. The sulphuric acid in Gabbet’s blue removes the carbol- fuchsin. from everything except the “acid-fast” bacteria, which remain red, and the blue stains the decolorized bacteria and nuclei of any tissue cells present. Rm whe or ZLiehl- Neelson method: 1, 2, 3, as in Gabbet’s method. 4. Decolorize with 10 per cent. HCl until washing with water shows only a faint pink color left on slide. 5. Wash thoroughly. 6. Stain with Léffler’s blue 1 or 2 minutes. 7. Wash, dry and examine. The results are the same as with Gabbet’s method. 13 194 STUDY OF INDIVIDUAL BACTERIA-STAINING Staining of Capsules.—Rdbiger’s Method—Films of the organism to show capsules should be freshly prepared, dried, but not fixed. The preparation is covered with a freshly prepared saturated solution of gentian violet in formalin and this allowed to stain for from 30 to 90 seconds. Then wash lightly, dry and examine. The organisms appear deeply violet and much larger than with ordinary stains and capsules are well stained and show well. Welch’s Method.—Prepare films as in the above method. Cover with glacial acetic acid for 10 to 20 seconds. Wash off the acid with carbol-fuchsin. Wash the stain off with physiological normal salt solution (0.85 per cent.) until all surplus stain is removed. Dry and examine. Capsules and bacteria are red. Staining of Flagella—The rendering of flagella visible is considered one of the most difficult processes in staining. Experience of a number of years during which whole classes numbering from one hundred to three hundred students accomplish this result shows that it is no more difficult than many other staining processes. The essentials are: (1) clean slides, (2) young cultures on agar slopes, (3) freshly prepared mordant and stain which are kept free from pre- cipitate, (4) gentle heating. The author’s students are fur- nished only stock materials and make their own cultures, mordants and stains. The slides are cleaned with pumice in the usual way. An agar slope culture of the organism to be stained from 6 to 24 hours old is selected. A bit of the culture is removed and placed in a watch-glass of water. The bacteria are allowed to diffuse of themselves without stirring. After several min- utes a loop of this water is removed and spread on the slide with a single movement of the needle, dried and carefully fixed. The film is then covered with an abundance of the mordant by filtering through a small filter onto the slide so that the mordant shows transparent on the slide. The preparation is then gently warmed and cooled three times, adding mordant if necessary. After mordanting for about five minutes the excess is washed off under the tap. It is a good plan to hold the slide level and allow the water to run into the center of the mordant and flow it off. Inclining the slide STAINING 195 is apt to cause the film on the surface of the mordant to settle down on the slide and spoil the preparation. After the mordant is washed off and all traces of it removed with a clean cloth if necessary the stain is applied and gently heated and cooled the same way for from three to five min- utes. The preparation is then washed, dried and examined. The mordant used is a modification of Léffler’s which is somewhat simpler in preparation since the stock solution of FeCl; is more permanent than FeSO, solution. Mordant sufficient for one student: 5 per cent. solution of FeCl; 20.0 ec. 25 per cent: solution of tannic acid . . 20.0 ¢.c. Anilin fuchsin : . 4.0 c.c. Normal NaOH es 1.5 c.c. The solution of FeCl; is made up in the cold and must be perfectly clear. The tannic acid solution must be thor- oughly boiled and filtered until clear. The iron and the acid are carefully mixed, boiled and filtered clear. The anilin fuchsin must be added slowly with constant stirring and the mixture boiled and filtered. The NaOH is added in the same way. The final mordant should not leave a film on a clean slide when poured on and allowed to run off. Unless the mordant is in this condition and perfectly clear, it should not be used, but a new one must be made up. Time and care in the preparation of the mordant are essential. The stain to follow this mordant is anilin fuchsin. By the use of the hanging drop slide and the methods of staining just described all the various morphological fea- tures of the bacterial cell may be ascertained. It is necessary when cell groupings as characteristic of definite modes of division are to be determined to make slides from a liquid culture, as broth. Place a drop of the material, preferably from the bottom of the tube in most instances, from the top in case a pellicle or scum is formed on the sur- face, on the slide and allow this to dry without spreading it out, then stain lightly with Léffler’s blue. Such slides also show characteristic cell forms as well. Slides should be made from solid media to show variations in form and size and involution forms. These latter are especially apt to occur on potato media, CHAPTER XxX. STUDY OF THE PHYSIOLOGY OF BACTERIA. Or the environmental conditions determining the growth of bacteria the following are the chief ones ordinarily deter- mined: A. Temperature.—The optimum temperature for growth is usually about the temperature of the natural environment and ordinarily one determines merely whether the organism grows at body temperature (37°) and at room temperature (20°) or not. For exact work the maximum, minimum and optimum temperature must be ascertained by growing in “incubators” with varying temperatures. A bacteriological incubator is an apparatus for growing bacteria at a constant temperature. This may be any tem- perature within the limits for bacterial growth. If tempera- tures above that of an ordinary room are desired, some source of. artificial heat is needed. Electricity, gas or oil may be used. A necessary adjunct is some device for maintaining the temperature constant, a “thermoregulator” or “ther- mostat.” For lower temperatures a cooling arrangement must be installed. For the great part of bacteriological work only two temperatures are used, 20° so-called “room tem- perature’ (this applies to European “rooms’’ not to Amer- ican) and 37° or body temperature. Incubators for 37° of almost any size and style desired may be secured from sup- ply houses and need not be further described. Figs. 139 and 140 illustrate some of the types. For use with large classes “incubator rooms” are to be preferred. The author has one such room for 37° work with 200 compartments for student use which did not cost over $60 to install. The styles of incubators for lower temperatures, 20° and below, are not so numerous nor so satisfactory. The author Fic. 140.—Electric incubator. 198 STUDY OF THE PHYSIOLOGY OF BACTERIA has constructed a device which answers every purpose for a small class. The diagram, Fig. 141, explains it. The thermal death-point is determined by exposing the organisms in thin tubes of broth at varying temperatures for ten-minute periods and then plating out to determine Fig. 141.—Diagram of fittings for a cold incubator. 1, small tank for constant head, about 1 foot in each dimension. a, inflow; b, overflow; c, lead pipe. 2, refrigerator. a’, ice; b’, flat coil under ice; c’, outflow to incubator. 3, incubator. a”, cold water inflow; b”, overflow; ther- mometer and burner omitted. The diagram explains the construction. The water cooled to about 14° with artificial ice by flowing through the lead coil under the ice, flows into the incubator which may be heated and regulated in the usual way. : growth. The effect of heat may also be determined by exposing at a given temperature, ec. g., 60°, for varying lengths of time and plating out. B. Oxygen relations—whether the organism is aérobic, anaérobic, or facultative is determined by inoculation in PHYSIOLOGICAL ACTIVITIES 199 gelatin or agar puncture or stab cultures and noting whether the most abundant growth is at the top, the bottom or all along the line of inoculation. C. Reaction of the medium—acid, alkaline or neutral as influencing the rate and amount of growth. D. The kind of medium on which the organism grows best. E. The effect of injurious chemicals, as various disinfec- tants, on the growth. F. Osmotic pressure conditions, though modifying decid- edly the growth of bacteria are not usually studied as aids in their recognition, nor are the effects of various forms of energy, such as light, electricity, x-rays, etc. Among the “Physiological Activities” discussed in Chap- ters IX—XIJ those which, in addition to the staining reac- tions described, are of most use in the identification of non-pathogenic bacteria are the first ten listed below. For pathogenic bacteria the entire thirteen are needed. 1. Liquefaction of gelatin. 2. Digestion of blood serum. 3. Coagulation and digestion of milk. 4, Acid or gaseous fermentation in milk, or both. 5. Acid or gaseous fermentation of various carbohydrates in carbohydrate broth, or both. 6. Production of indol in “indol solution.” _ 7. Production of pigments on various media. 8. Reduction of nitrates to nitrites, ammonia, or free nitrogen. 9. Production of enzymes as illustrated in the above activities. 10. Appearance of growth on different culture media. 11. Production of free toxins as determined by injection of animals with broth cultures filtered free from bacteria. 12. Causation of disease as ascertained by the injection of animals with the bacteria themselves, and recovery of the organism from the animals. 13. Formation of specific antibodies as determined by the proper injection of animals with the organism or its products and the subsequent testing of the blood serum of the inocu- lated animals. 200 STUDY OF THE PHYSIOLOGY OF BACTERIA For special kinds of bacteria other activities must be determined (oxidation, nitrate and nitrite formation, action of sulphur and iron bacteria, etc.). : The first nine activities are determined by inoculating the different culture media already described and observ- ing the phenomena indicated, making chemical tests where necessary. APPEARANCE OF GROWTH ON DIFFERENT CULTURE MEDIA. In addition to those changes that are associated with the manifestation of different physiological activities of bacteria, many show characteristic appearances on the various cul- ture media which are of value in their identification. Too much stress should not be laid on these appearances alone, however, since slight variations, particularly in solid media due especially to the age of the medium, may change decidedly the appearance of a colony. This is true of variations in the amount of moisture on agar plates. Colonies which are ordinarily round and regular may assume very diverse shapes, if there chance to be an excess of moisture on the surface. Also in slope and puncture cultures on the various solid media much variation results from the amount of material on the inoculation needle and just how the puncture is made, or the needle drawn over the slope. These variations are largely prevented by the use of standard media and by inoculating by standard methods. The Laboratory Com- mittee of the American Public Health Association has pro- posed standard methods for all culture media and tests and for methods of inoculation, and these have been generally adopted in this country for comparative work. Likewise the Society of American Bacteriologists has adopted a standard “descriptive chart’’ for detailing the characteristics of a given organism which includes the terms to be used in describing the appearance on different culture media. This chart is inserted in this chapter. Missing Page Missing Page Missing Page GROWTH ON DIFFERENT CULTURE MEDIA 201 Among the cultural appearances the following are of most importance: Fic. 142.—Broth cultures X 3. 1, uninoculated transparent broth; 2, broth cloudy from growth of organisms; 3, broth slightly cloudy with a deposit,in bottom; 4, broth slightly cloudy with a heavy membrane at the surface. In broth cultures the presence or absence of growth on the surface and ‘the amount of the same. Whether the 202 STUDY OF THE PHYSIOLOGY OF BACTERIA broth is rendered cloudy or remains clear, and whether there is a deposit at the bottom or not (Fig. 142). An abundant surface growth with little or nothing below indicates a strict aérobe, while a growth or deposit at bottom and a clear or nearly clear medium above an anaérobe. These appear- Fia. 143.—A _fili- Fic. 144.—A beaded Fig. 145.—A vill- form stab or punc- stab or puncture cul- ous stab or puncture ture culture. xX #. ture. xX #. culture. X }. ances are for the first few days only of growth. If the broth is disturbed, or after the culture stands for several days many surface growths tend to sink to the bottom. So an actively motile organism causes in general a cloudiness, especially if the organism is a facultative anaérobe, which tends to clear up by precipitation after several days when GROWTH ON DIFFERENT CULTURE MEDIA 203 the organisms lose their motility. _Non-motile facultative anaérobes usually cloud the broth also, but settle out more rapidly than the motile ones. Fig. 146 Fic. 147 Fie. 148 Fig. 149 Fic. 146.—Crateriform liquefaction of gelatin. ae Fic. 147.—Funnelform liquefaction of gelatin. xX 4. Fig. 148.—Saccate liquefaction of gelatin. x }. Fic. 149.—Stratiform liquefaction of gelatin. 4. In gelatin and agar punctures the oxygen relationship is shown by surface growth for aérobes, growth near the bottom of the puncture for anaérobes, and a fairly uniform growth all along the line of inoculation for facultative 204. STUDY OF THE PHYSIOLOGY OF BACTERIA anaérobes. In the case of these last organisms, a preference for more or less oxygen is indicated by the approach to the aérobic or anaérobic type of growth. Fie. 150.—Filiform Fic. 151.—Filiform, Fig. 152.—Beaded slope culture. }. slightly spreading, slope culture. X 3. slope culture. x 3. Along the line of puncture the commonest types are filiform (Fig. 143), which indicates a uniform growth; beaded (Fig. 144), or small separate colonies; willous (Fig. 145), deli- cate lateral outgrowths which do not branch; arborescent, tree-like growths branching laterally from the line. In agar these branchings are usually short and stubby, or technically, papillate. . GROWTH ON DIFFERENT CULTURE MEDIA 205 Further, in the gelatin puncture the liquefaction which occurs is: frequently characteristic. It may be crateriform (Fig. 146), a shallow saucer at the surface; or funnel-shaped Fig. 153 Fic. 154 Fre. 155 Fic. 156 Fic. 153.—Effuse slope culture. x 3. Fic. 154.—Rhizoid slope culture. x Fig. 155.—Rugose slope culture.. x Fic. 156.—Verrucose slope culture. (Fig. 147); or it may be of uniform width all along the puncture, 2. ¢., saccate (Fig. 148); or it may be stratiform, (Fig. 149), 2. e., the liquefaction extends to the sides of the tube and proceeds uniformly downward, . 206 STUDY OF THE PHYSIOLOGY OF BACTERIA On agar, potato and blood serum slope tubes the amount of growth, its form and elevation, the character of the sur- Fic. 157.—Punctiform colonies on a plate. 3. Fic. 158.—A rhizoid colony on a plate. Natural size. GROWTH ON DIFFERENT CULTURE MEDIA 207 face, and the consistency should be carefully noted, and in some few cases the character of the edge. Figures 150 to 156 show some of the commoner types. Fie. 159.—Ameboid colonies on a plate. x }. Fic. 160.—Large effuse colony on a plate. The edge is lacerated. Inci- dentally the colony shows the rate of growth for six successive days. X 3. 208 STUDY OF THE PHYSIOLOGY OF BACTERIA Fig. 161.—Colony with edge entire Fic. 162.—Colony with edge as seen under the low-power objective. coarsely granular as seen under xX 100° the low-power objective. 100. Fig. 163.—Colony with edge Fig. 164.—Colony with edge rhiz- curled as seen under the low-power oid as seen under the low-power objective. > 100. objective. > 100. \ * j SS 5 a= IIa. 165,—A sinall deep rhizoid colony as seen under the low-power objective. x 100, C GROWTH ON DIFFERENT CULTURE MEDIA 209 On agar and gelatin plates made so that the colonies are well isolated, the form of the latter, the rate of their growth, the character of the edge and of the surface, the elevation and the interna! structure as determined by a low-power lens are often of almost diagnostic value. Also in the case of the gelatin plates, the character of the liquefaction is important. Figs. 157 to 165 show some of the commoner characteristics to be noted. 14 CHAPTER XXI. ANIMAL INOCULATION. ANIMAL inoculation has been referred to (1) as a method of assisting in the preparation of pure cultures of patho- genic organisms; (2) as a means of testing the poisonous properties of substances produced in bacterial cultures; (3) in order to test the ability of an organism to cause a disease; (4) for the production of various antibodies; it may be added (5) that some bacteria produce in the smaller experimental animals lesions which do not occur in animals naturally infected, but which nevertheless are characteristic for the given organism. The best illustration is the testicular reac- tion of young male guinea-pigs to intraperitoneal injections of glanders bacilli. Experimental animals are also inocu- lated (6) to test the potency of various bacterial and other biological products, as toxins, antitoxins, etc. Guinea-pigs are the most widely used experimental animals because they are easily kept and are susceptible to so many diseases on artificial inoculation. Rabbits are used very largely also, as are white mice. For special purposes white rats, pigeons, goats and swine are necessary. For commercial products horses (antitoxins) and cattle (small- pox vaccine) are employed. In the study of many human diseases the higher monkeys and even the anthropoid apes are necessary, since none of the lower animals are susceptible. The commonest method of animal inoculation is undoubt- edly the subcutaneous. This is accomplished most readily with the hypodermic needle. The skin at the point selected (usually in guinea-pigs the lateral posterior half of the abdominal surface, in mice the back near the root of the tail) is pinched up to avoid entering the muscles and the needle quickly inserted. Clipping the hairs and washing with an antiseptic solution should precede the inoculation as routine practice. Frequently a small “skin pocket’ is all that is needed. The hair is clipped off, the skin pinched up with small forceps and a slight snip with sharp scissors ANIMAL INOCULATION 211 is made. The material may be inserted into this pocket with a heavy platinum needle. Cutaneous inoculation is made by shaving the skin and rubbing the material onto the shaved surface or scratching with a scalpel or special scarifier, but without drawing blood, and then rubbing in the material to be inoculated. Intravenous injections are made with larger animals. In rabbits the posterior external auricular is a convenient vein. In larger animals the external jugular is used. Intraperitoneal, -thoracic, -cardiac, -ocular, -muscular injec- tions, and injections into the parenchyma of internal organs are accomplished with the hypodermic needle. In the case of the first two, injury to contained organs should be care- fully avoided. Intracardiac injection, or aspiration of the heart to secure blood, requires considerable practice to be successful without causing the death of the animal at once through internal hemorrhage. In subdural injections into the cranial cavity it is necessary to trephine the skull first, while such injections into the spinal canal may be accom- plished between the vertebra with needles longer and stronger than the usual hypodermic needle. Occasionally animals are caused to whale the organisms, or are fed cultures mixed with the feed. SECURING AND TRANSPORTING MATERIAL FROM ANIMALS FOR BACTERIOLOGICAL EXAMINATION. If the site of the lesion is readily accessible from the exterior, material from the living animal should be collected with sterile instruments and kept in sterile utensils until the necessary tests can be made. Testing should be done on material as soon after collection as possible, in all cases, to avoid the effects of ‘“decomposition’’ bacteria. If the blood is to be investigated it may be aspirated from a peripheral vein with a sterile hypodermic syringe of appro- priate size or allowed to flow through a sterile canula into sterile receptacles. The site of the puncture should be shaved and disinfected before the instrument is introduced. Discharges of whatever kind should likewise be collected in sterile receptacles and examined as soon as may be. 212 ANIMAL INOCULATION If internal organs are to be examined it is best to kill a moribund animal than to wait for death, since after death, and in severe infections even sometimes before, the tissues are rapidly invaded by saprophytic bacteria from the ali- mentary and respiratory tracts which complicate greatly the isolation of the specific organism. Hence the search for specific bacteria in carcasses or on organs several hours after death is frequently negative. Animal inoculation with such material is very often followed by sepsis or septicemia in a few hours, so that the specific organism has no opportunity to manifest itself. In securing material for cultures from internal organs it is a good plan to burn the surface of the organ with a gas or alcohol flame, or to sear it with a hot instrument to kill surface organisms, then make the incision or puncture through the burned area and secure material from the inte- rior of the organ. Such punctures made with a stiff platinum needle frequently give pure cultures of the organism sought. Slides may be made from such material and culture media inoculated at once Since a bacteriological diagnosis depends most commonly on growing the organisms, it is evident that material sent for examination must never be treated with an antiseptic or pre- servative. If decomposition is to be feared the only safe pro- cedure is to pack the material in ice and forward in this way. Tuberculous material from the parenchyma of internal organs may be forwarded in a preservative (not formalin, since this makes it very difficult to stain the bacteria) as in this special case a very positive diagnosis may be made by staining alone. Even here it is better to pack in ice in order that the diagnosis by staining may be confirmed by inoculating the living organisms into guinea-pigs. In the case of material from a rabid animal and many protozoal diseases the rule against preservatives is not abso- lute, since staining is a reliable diagnostic means. Even in these cases it is often desirable to inoculate animals, hence, as before stated, it is best to make it a uniform practice to pack material for examination in ice and use no preservatives. PART IV. GENERAL PATHOGENIC BACTERI- OLOGY. CHAPTER XXII. INTRODUCTION. PatuoceEntc Bacteriology treats of the unicellular micro- organisms which are responsible for disease conditions, i. e., pathological changes in other organisms. Hence not only are bacteria considered, but also other low vegetable forms, as yeasts and molds, likewise protozoa insofar as they may be pathogenic. For this reason the term pathogenic “Microbiology” has been introduced to include all these organisms. It is largely for the reason that the methods devised for the study of bacteria have been applied to the investigation of other microérganisms that the term ‘‘bac- teriology’’ was extended to cover the entire field. The general discussion in this chapter is intended to include, therefore, microérganisms of whatever kind pathogenic to animals. The term pathogenic as applied to an organism must be understood in a purely relative sense, since there is no single organism that can cause disease in all of a certain class, but each is limited to a more or less narrow range. Some form _ of tuberculosis attacks nearly all vertebrates, but no other classes of animals and no plants. Lockjaw or tetanus attacks most mammals, but not any other vertebrates naturally. Typhoid fever affects human beings; hog cholera, swine, etc. Diseases which are due to unicellular pathogenic micro- organisms are called infectious diseases, while if such diseases 214 INTRODUCTION are transmitted under natural conditions from organism to organism they are spoken of as contagious diseases. Most infectious diseases are contagious but not all. Tetanus is a good illustration of a non-contagious infectious disease. There are very few such diseases. When a unicellular microérganism gains entrance into the body and brings about any pathological changes there the result is an infection. Undoubtedly many pathogenic organ- isms get into the body but never manifest their presence by causing disease conditions, hence do not cause an infection. It is the pathological conditions which result that constitute the infection and not the mere invasion. The time that elapses between the entrance of the organ- ism and the appearance of symptoms is called the period of incubation and varies greatly in different diseases. The term infestation is used to denote pathological condi- tions due to multicellular parasites. Thus an animal is infested (not infected) with tapeworms, roundworms, lice, mites, etc. Many of these conditions, probably all, are contagious, 7. e., transmissable naturally from animal to animal. The word contagious has been used in a variety of ways to mean communicated by direct contact, communi- cated by a living something (contagium) that might be car- ried to a distance and finally communicable in any manner, transmissible. The agency of transmission may be, very roundabout—as through a special tick in Texas fever, a mosquito in malaria, etc., or by direct personal contact, as generally in venereal diseases. After all, though exactness is necessary, it is better to learn all possible about the means of transmission of diseases, than quibble as to the terms to be used. An infectious disease may be acute or chronic. An acute infection is one which runs for a relatively short time and is “‘self-limited,” so-called, 7. e., the organisms cease to mani- fest their presence after a time. In some acute infections the time is very short—German measles usually runs five or six days. Typhoid fever may continue eight to ten weeks, sometimes longer, yet it is an acute infectious dis- ease. It is not so much the time as the fact of self-limita- tion that characterizes acute infections. INTRODUCTION 215 In chronic infections there is little or no evidence of limi- tation of the progress of the disease which may continue for years. Tuberculosis is usually chronic. Leprosy in man is practically always so. Glanders in horses is most commonly chronic; in mules and in man it is more apt to be acute. Many infections begin acutely and later change to the chronic type. Syphilis in man is a good illustration. The differences between acute and chronic infections are partly due to the nature of the organism, partly to the num- ber of organisms introduced and the point of their intro- duction and partly to the resistance of the animal infected. An infectious disease is said to be specific when one kind of organism is responsible for its manifestations—as diph- theria due to the Bacterium diphtherie, lockjaw due to Bacillus tetani, Texas fever due to the Piroplasma bigeminum, etc. It-is non-specific when it may be due to a variety of organisms, as enteritis (generally), bronchopneumonia, wound infections. Henle, as early as 1840, stated certain principles that must be established before a given organism can be accepted as the cause of a specific disease. These were afterward restated by Koch, and have come to be known as “ Koch’s postulates.”” They may be stated as follows: 1. The given organism must be found in all cases of the disease in question. 2. No other organism must be found in all cases. 8. The organism must, when obtained in pure culture, reproduce the disease in susceptible animals. 4. It must be recovered from such animals in pure cul- ture and this culture likewise reproduce the disease. These postulates have not been fully met with reference to any disease, but the principles embodied have been applied as far as possible in all those infections which we recognize as specific, and whose causative agent is accepted. In many recognized infectious and contagious diseases no organism has been found which is regarded as the specific cause. In some of these the organism appears to be too small to be seen with the highest powers of the microscope, hence they are called “wuléramicroscopic”’ organisms. Because these agents pass through the finest bacterial filters, they are also 216 INTRODUCTION frequently called “‘filterable.” The term “virus” or “ filter- able virus” is likewise applied to these “ ultra-microscopic” and “‘filterable”’ agents. The term primary infection is sometimes applied to the first manifestation of a disease, either specific or non- specific, while secondary refers to later developments. For example, a secondary general infection may follow a primary wound infection, or primary lung tuberculosis be followed by secondary generalized tuberculosis, or primary typhoid fever by a secondary pneumonia. Where several organisms seem to be associated simultaneously in causing the condition then the term mixed infection is used— in severe diphtheria, streptococci are commonly associated with the Bacterium diphtherie. In many cases of hog- cholera, mixed infections in the lungs and in the intestines are common. Wound infections are usually mixed. Auto- infection refers to those conditions in which an organism commonly present in or on the body in a latent or harmless condition gives rise to an infectious process. If the Bacillus coli normal to the intestine escapes into the peritoneal cavity, or passes into the bladder, a severe peritonitis or cystitis, respectively, is apt to result. ‘‘Boils’’ and “pimples’’ are frequently autoinfections. Such infections are also spoken of as endogenous to distinguish them from those due to the entrance of organisms from without—erogenous infec- tions. Relapses are usually instances of autoinfection. Those types of secondary infection where the infecting agent is transferred from one disease focus to another or several other points and sets up the infection there are sometimes called metastases. Such are the transfer of tubercle bacilli from lung to intestine, spleen, etc., the for- mation of abscesses in internal organs following a primary surface abscess, the appearance of glanders nodules through- out various organs following pulmonary glanders, etc. The characteristic of a pathogenic microérganism which indicates its ability to cause disease is called its virulence. If slightly virulent, the effect is slight, if highly virulent, the effect is severe, may be fatal. On the other hand, the characteristic of the host which indicates its capacity for infection is called susceptibility. INTRODUCTION 217 If slightly susceptible, infection is slight, if highly suscep- tible, the infection is severe. Evidently the degree of infection is dependent in large measure on the relation between the virulence of the in- vading organism and the susceptibility of the host. High virulence and great susceptibility mean a severe infection; low virulence and little susceptibility, a slight infection; while high virulence and little susceptibility or low viru- lence and great susceptibility might mean a moderate infec- tion varying in either direction. Other factors influencing the degree of infection are the number of organisms intro- duced, the point where they are introduced and various conditions. These will be discussed in another connection (Chapter XXV). The study of pathogenic bacteriology includes the thor- ough study of the individual organisms according to the methods already given (Chapters XVII-XXJ) as an aid to diagnosis and subsequent treatment, bacteriological or other, in a given disease. Of far greater importance than the treatment, which in most infectious diseases is not specific, is the prevention and ultimate eradication of all infectious diseases. To accomplish these objects involves further a study of the conditions under which pathogenic organisms exist outside the body, the paths of entrance into and elimina- tion from the body and those agencies within the body itself which make it less susceptible to infection or overcome the infective agent after its introduction. That condition of the body itself which prevents any manifestation of a virulent pathogenic organism after it has been once introduced is spoken of as immunity in the modern sense. Immunity is thus the opposite of susceptibility and may exist in varying degrees. That scientists are and have been for some years in posses- sion of sufficient knowledge to permit of the prevention and . eradication of most, if not all, of our infectious diseases can scarcely be questioned. The practical application of this knowledge presents many difficulties, the chief of which is the absence of a public sufficiently enlightened to permit the expenditure of the necessary funds. Time and educative effort alone can surmount this difficulty. It will probably be years yet, but it will certainly be accomplished. CHAPTER XXIII. PATHOGENIC BACTERIA OUTSIDE THE BODY. PATHOGENIC bacteria may exist outside the body of the host under a variety of conditions as follows: I. In or on inanimate objects or material. (a) As true saprophytes. (b) As facultative saprophytes. (c) Though obligate parasites, they exist in a latent state. II. In or on other animals, or products from them: (a) Sick themselves. (b) Recovered from illness but carrying the organisms. (ec) Never sick with the disease but carrying the organisms. (d) Serving as necessary intermediate hosts for cer- tain stages of the parasite—this applies to protozoal diseases only, as yet. I. (a) The bacilli of tetanus and malignant edema are widely distributed. There is no evidence that their entrance into the body is at all necessary for the continuation of their life processes, or that one case of either of these diseases ever has any connection with any other case; they are true saprophytes. Manifestly it would be futile to attempt to prevent or eradicate such diseases by attacking the organ- ism in its natural habitat. Bacillus botulinus, which causes a type of meat poisoning in man, does not even multiply in the body, but the disease symptoms are due to a soluble toxin which is produced during its growth outside the body. (b) Organisms like the bacterium of anthrax and the bacillus of black-leg from their local occurrence seem to be distributed from animals infected, though capable of living a saprophytic existence outside the body for years. These can no more be attacked during their saprophytic existence ' PATHOGENIC BACTERIA OUTSIDE THE BODY 219 than those just mentioned. Doubtless in warm seasons of the year and in the tropics other organisms pathogenic to animals may live and multiply in water or in damp soil where conditions are favorable, just as the cholera organism in India, and occasionally the typhoid bacillus in témperate climates do. (c) Most pathogenic organisms, however, when they are thrown off from the bodies of animals, remain quiescent, do not multiply, in fact always tend to die out from lack of all that is implied in a “favorable environment,” food, moisture, ’ temperature, light, ete. Disinfection is sometimes effective in this class of diseases in preventing new cases. II. (a) The most common infectious diseases of animals are transmitted more or less directly from other animals of the same species. Human beings get nearly all their dis- eases from other human beings who are sick; horses, from other horses; cattle, from other cattle; swine, from swine, ete. Occasionally transmission from one species to another occurs. Tuberculosis of swine most frequently results from feeding them milk of tuberculous cattle or from their eating the droppings of such cattle. Human beings contract anthrax from wool, hair and hides of animals dead of the disease, or from postmortems on such animals; glanders from horses; tuberculosis (in children) from tuberculous milk; bubonic plague from rats, etc. The mode of limiting this class of diseases is evidently to isolate the sick, dis- infect their discharges and their immediate surroundings, sterilize such products as must be handled or used, kill dangerous animals, and disinfect, bury properly, or destroy their carcasses. (b) This class of “carriers” offers one of the most difficult problems in preventing infectious diseases. A perfectly healthy individual may give off dangerous organisms and infect others for years. Typhoid carriers have been known to do so for fifty-five years. Cholera, diphtheria, menin- gitis and other carriers are well known in human practice. The difficulty in detecting such individuals is obvious. Carriers among animals have not been so frequently demon- strated, but there is every reason for thinking that hog- 220 PATHOGENIC BACTERIA OUTSIDE THE BODY cholera, distemper, roup, influenza and other carriers are common. Carriers furnish the explanation for many of the so-called ‘‘spontaneous” outbreaks of disease among men and animals. (c) In this class come the “accidental carriers” like flies, fleas, lice, bed-bugs, ticks and other biting and blood- -sucking insects, vultures, buzzards, foxes, rats and carrion- eating animals generally; pet animals in the household, etc. Here the animals are not susceptible to the given disease but become contaminated with the organisms and then through defilement of the food or drink, or contact with individuals or with utensils pass the organisms on to the susceptible. Some biting and blood-sucking insects transmit the organisms through biting infected and non-infected ani- mals successively. The spirilloses and trypanosomiases seem to be transmitted in this way, though there is evidence accumulating which may place these diseases in the next class. Anthrax is considered in some instances to be trans- mitted by flies and by vultures in the southern United States. Typhoid transmission by flies is well established in man. Why not hog-cholera from farm to farm by flies, English sparrows, pigeons feeding, or by turkey buzzards? Though this would not be easy to prove, it seems reasonable. Preventing contact of such animals with the discharges or with the carcasses of those dead of the disease, destruc- tion of insect carriers, screening and prevention of fly breed- ing are obvious protective measures. (d) In this class come certain diseases for which particu- lar insects are necessary for the parasite in question, so that certain stages in its life history may be passed therein. The most certain, means for eradicating such diseases is the destruction of the insects concerned. Up to the present no bacterial disease is known in which this condition exists, unless Rocky Mountain spotted fever and typhus fever shall prove to be due to bacteria. Such diseases are all due to protozoa. Among them are Texas fever, due to Piroplasma bigeminum in this country which has been eradicated in entire districts by destruction of the cattle tick (Margaropus annulatus). Piroplasmoses in South ‘Africa among cattle and horses, PATHOGENIC BACTERIA OUTSIDE THE BODY 221 and in other countries are transmitted in similar ways. Prob- ably many of the diseases due to spirochetes and trypano- somes are likewise transmitted by necessary insect inter- mediaries. In human medicine the eradication of yellow fever from Panama and Cuba is due to successful warfare against a certain mosquito (Stegomyia). So the freeing of large areas in different parts of the world from malaria follows the destruction of the mosquitoes. The campaign against disease in animals and man from insect sources must be considered as still in its infancy. The full utiliza- tion of tropical lands depends largely on the solution of this problem. CHAPTER XXIV. PATHS OF ENTRANCE OF PATHOGENIC ORGANISMS, OR CHANNELS OF INFECTION. A, The Skin.—If the skin is healthy there is no oppor- tunity for bacteria to penetrate it. It is protected not only by the stratified epithelium, but also in various animals, by coats of hair, wool, feathers, etc. The secretion pressure of the healthy sweat and oil glands acts as an effective bar even to motile bacteria. Nevertheless a very slight injury only is sufficient to give normal surface parasites and other pathogenics, accidentally or purposely brought in contact with it, an opportunity for more rapid growth and even entrance for general infection. Certain diseases due to higher fungi are characteristically “skin diseases” and rarely become general—various forms of Favus, Trychophyton in- fections, etc. A few disease organisms, tetanus, malignant edema, usually get in through the skin; others, black-leg, anthrax, quite commonly; and those diseases transmitted by biting and blood-sucking insects, piroplasmoses, trypano- somiases, spirilloses, scarcely in any other way. Defective secretion in the skin glands from other causes, may permit lodgment and growth of bacteria in them or in the hair follicles. “Pimples” and boils in man and local abscesses occa- sionally in animals are illustrations. Sharp-edged and freely bleeding wounds are less liable to be infected than contu- sions, ragged wounds, burns, etc. The flowing blood washes out the wound and the clotting seals it, while there is less material to be repaired by the leukocytes and they are free THE SKIN 223 to care for invading organisms (phagocytosis). Pathogenic organisms, especially pus cocci, frequently gain lodgment in the malk glands and cause local (mastitis) or general infection. B. Mucose directly continuous with the skin and lined with stratified epithelium are commonly well protected thereby and by the secretions. (a) The eaternal auditory meatus is rarely the seat of even local infection. The tympanic cavity is normally sterile, though it may become infected by extension through the Eustachian tube from the pharynx (otitis media). (b) The conjunctiva is frequently the seat of localized, very rarely the point of entrance for a generalized infection, except after severe injury. (c) The nasal cavity, on account of its anatomical structure retains pathogenic organisms which give rise to local infec- tions more frequently than other mucose of its character. These may extend from here to middle ear, neighboring sinuses, or along the lymph spaces of the olfactory nerve into the cranial cavity (meningitis). Acute coryza (‘‘colds” in man) is characteristic. Glanders, occasionally, is primary in the nose, as is probably roup in chickens, leprosy in man. The meningococcus and the virus of poliomyelitis pass from the nose into the cranial cavity without local lesions in the former. (d) The mouth cavity is ordinarily protected by its epi- thelium and secretions, though the injured mucosa is a common source of actinomycosts infection, as well as thrush. In foot-and-mouth disease no visible lesions seem necessary to permit the localization of the unknown infective agent. (e) The tonsils afford a ready point of entrance for ever- present micrococct and streptococci whenever occasion offers (follicular tonsilitis, “quinsy’’), and articular rheumatism is not an uncommon sequel. The diphtheria bacillus charac- teristically seeks these structures for its development. Tubercle and anthrax organisms occasionally enter here. (f) The pharynx is the seat of localized infection as in macrococcal, streptococcal and diphtherial “sore throat” in human beings, but both it and the esophagus are rarely infected in animals except as the result of injury. 224 ENTRANCE OF PATHOGENIC ORGANISMS (g) The external genitalia are the usual points of entrance for the venereal organisms in man (gonococcus, T'reponema pallidum, and Ducrey’s bacillus). The bacillus of contagious abortion and probably the trypanosome of dourine are commonly introduced through these channels in animals. C. Lungs.—The varied types of pneumonia due to many different organisms (tubercle, glanders, influenza, plague bacilli, pneumococcus, streptococcus, micrococcus and many others) show how frequently these organs are the seat of a localized infection, which may or may not be general. Whether the lungs are the actual point of entrance in these cases is a question which is much discussed at the present time, particularly with reference to tuberculosis. The mucous secretion of the respiratory tract tends to catch incoming bacteria and other small particles and the ciliary movement along bronchial tubes and trachea tends to carry such material out. “Foreign body pneumonia”’ shows. clini- cally, and many observers have shown experimentally that microdrganisms may reach the alveoli even though the exchange of air between them and the bronchioles and larger bronchi takes place ordinarily only by diffusion. The pres- ence of carbon particles in the walls of the alveoli in older animals and human beings and in those that breathe dusty air for long periods indicates strongly, though it does not prove absolutely, that these came in with inspired air. On the other hand, experiment has sbown that tubercle bacilli introduced into the intestine may appear in the lungs and cause disease there and not in the intestine. It is probably safe to assume that in those diseases which are transmitted most readily through close association though not neces- sarily actual contact, the commonest path is through the lungs, which may or may not show lesions (smallpox, scar- let fever, measles, chicken-pox, whooping-cough, pneumonic plague in man, lobar and bronchopneumonias and influenza in man and animals, some cases of glanders and tubercu- losis). On the other hand, the fact that the Bacillus typhosus and Bacillus coli may cause pneumonia when they evi- dently have reached the lung from the intestinal tract, and the experimental evidence of lung tuberculosis above men- DISSEMINATION OF ORGANISMS 225 tioned show that this route cannot be excluded in inflam- mations of the lung. D. Alimentary Tract.—The alimentary tract affords the ordinary path of entrance for the causal microbes of many of the diseases of animals and man, since they are carried into the body most commonly and most abundantly in the food .and drink. (a) The stomach is rarely the seat of local infection, even in ruminants, except as the result of trauma. The character of the epithelium in the rumen, reticulum and omasum in ruminants, the hydrochloric acid in the abomasum and in the stomachs of animals generally are usually sufficient pro- tection. Occasionally anthrax “pustules” develop in the gastric mucosa. (The author saw nine such pustules in a case of anthrax in a man.) (b) The intestines are frequently the seat of localized infections, as various “choleras’”’ and “dysenteries” in men and many animals, anthrax, tuberculosis, Johne’s disease. Here doubtless enter the organisms causing “hemorrhagic septicemias” in many classes of animals, and many others. These various organisms must have passed through the stomach and the question at once arises, why did the HCl not destroy them? It must be remembered that the acid is present only during stomach digestion, and that liquids taken on an “empty stomach” pass through rapidly and any organisms present are not subjected to the action of the acid. Also spores generally resist the acid. Other organisms may pass through the stomach within masses of undigested food. The fact that digestion is ‘going on in the stomach of ruminants practically all the time may explain the relative freedom of adult animals of this class from “choleras” and “ dysenteries.” Dissemination of Organisms.—Dissemination of organisms within the tissues occurs either through the lymph channels or the bloodvessels or both. If through the lymph vessels only it is usually much more restricted in extent, or much more slowly disseminated, while blood dissemination is characterized by the number of organs involved simul- taneously. 15 226 ENTRANCE OF PATHOGENIC ORGANISMS PATHS OF ELIMINATION OF PATHOGENIC MICRO- ORGANISMS. I. Directly from the point of injury. This is true in infected wounds open to the surface, skin glanders (farcy), black-leg, surface anthrax, exanthemata in man and animals [scarlet fever (?), measles (?), smallpox; hog erysipelas, foot- and-mouth disease]. Also in case of disease of mucous mem- branes continuous with the skin—from nasal discharges (glanders), saliva (foot-and-mouth disease), material coughed or sneezed out (tuberculosis, influenza, pneumonias), ure- thral and vaginal discharges (gonorrhea and syphilis in man, contagious abortion and dourine in animals), intestinal dis- charges (typhoid fever, “choleras,” ‘‘dysenteries,”’ anthrax, tuberculosis, Johne’s disease). Material from nose, mouth and lungs may be swallowed and the organisms passed out through the intestines. II. Indirectly through the secretions and the excretions where the internal organs are involved. The saliva of rabid animals contains the ultra-microscopic virus of rabies (the sympathetic ganglia within the salivary glands, and pan- creas also, are affected in this disease as well as the cells of the central nervous system). The gall-bladder in man is known to harbor colon and typhoid bacilli, as that of hog- cholera hogs does the virus of this disease. It may harbor analogous organisms in other animals, though such knowl- edge is scanty. The kidneys have been shown experimen- tally to excrete certain organisms introduced into the circu- lation within a few minutes (micrococci, colon and typhoid bacilli, anthrax). Typhoid bacilli occur in the urine of typhoid-fever patients in about 25 per cent. of all cases and the urine of hogs with hog cholera is highly virulent. Most observers are of the opinion, however, that under natural conditions the kidneys do not excrete bacteria unless they themselves are infected. The milk both of tuberculous cattle and tuberculous women has been shown to contain tubercle bacilli even when the mammary glands are not involved. LOCATION OF INFECTIVE ORGANISMS 227 SPECIFICITY OF LOCATION OF INFECTIVE ORGANISMS. It is readily apparent that certain disease organisms tend to locate themselves in definite regions and the question arises, Is this due to any specific relationship between organ- ism and tissue or not? Diphtheria in man usually attacks the tonsils first, gonorrhea and syphilis the external geni- tals, tuberculosis the lung apex (in man most commonly), “choleras” the small intestine, “dysenteries” the large intestine, influenza the lungs. In these cases the explana- tion is probably that the points attacked are the places where the organism is most commonly carried, with no specific relationship, since all of these organisms (Asiatic cholera, excepted) also produce lesions in other parts of the body when they reach them. On the other hand, the virus of hydrophobia attacks nerve cells, leprosy frequently singles out nerves, glanders bacilli introduced into the abdominal cavity of a young male guinea-pig cause an inflammation of the testicle, malarial parasites and piroplasms attack the red blood corpuscles, etc. In these cases there is apparently a real chemical relationship, as there is also between the toxins of bacteria and certain tissue cells (tetanus toxin and nerve cells). Whether “chemotherapy” will ever profit from a knowledge of such chemical relationships remains to be developed. CHAPTER XXV. IMMUNITY. Immunity, as has already been stated, implies such a con- dition of the body that pathogenic organisms after they have been introduced are incapable of manifesting them- selves, are unable to cause disease. The word has taken the place of the earlier term, resistance, and is the opposite of susceptibility. The term must be understood always in a relative sense, since no animal is immune to all pathogenic organisms, and conceivably not entirely so to anyone, since there is no question that a sufficient number of bacteria of any kind might be injected into the circulation to kill an animal, even though it did it purely mechanically. Immunity may be considered with reference to a single individual or to entire divisions of the organic world, with all grades between. Thus plants are immune to the diseases affecting animals; invertebrates to vertebrate diseases; cold- blooded animals to those of warm blood; man is immune to most of the diseases affecting other mammals; the rat to anthrax, which affects other rodents and most mammals; the well-known race of Algerian sheep is likewise immune to anthrax while other sheep are susceptible; the negro appears more resistant to yellow fever than the white; some few individuals in a herd of hogs always escape an epizootic of hog cholera, ete. Immunity within a given species is modified by a number of factors—age, state of nutrition, extremes of heat or cold, fatigue, excesses of any kind, in fact, anything which tends to lower the ‘normal healthy tone” of an animal also tends to lower its resistance. Children appear more susceptible to scarlet fever, measles, whooping-cough, etc., than adults; young cattle more frequently have black-leg than older ones IMMUNITY 229 (these apparently greater susceptibilities may be due in part to the fact that most of the older individuals have had the diseases when young and are immune for this reason). Ani- mals weakened by hunger or thirst succumb to infection more readily. Frogs and chickens are immune to tetanus, but if the former be put in water and warmed up to and kept at about 37°, and the latter be chilled for several hours in ice-water, then each may be infected. Pneumonia fre- quently follows exposure to cold. The immune rat may be given anthrax if first he is made to run in a “squirrel cage” until exhausted. Alcoholics are‘far less resistant to infec- tion than temperate individuals. ‘“ Worry,’ mental anguish, tend to predispose to infection. The following outlines summarize the’ different classifi- cations of immunity so far as mammals are concerned for the purposes’ of discussion: Immunity. f 1. Inherited through the germ cell or cells. (a) By having the disease in utero. | 2. Acquired in utero. } (b) By absorption of immune sub- B. Acquired by having the disease. stances from the mother. _ : A. Congenital I. Natural II. Artificial—acquired through human agency by: 1. Introduction of the organism or its products. 2. Introduction of the blood serum of an immune animal. Immunity. I. Active—due to the introduction of the organism or due to the intro- duction of the products of the organism. A. Naturally by having the disease. B. Artificially. 1. By introducing the organism: 1. Passage through another animal. 2. Drying. (a) Alive and virulent. 3. Growing at a higher temperature. (b) Aliveand virulence reduced b 4, Heating the cultures. (c) D d. ¥ 5. Treating with chemicals. aes 6. Sensitizing. 7. Cultivation on artificial media. 2. By introducing the products of the organism. II. Passive—due to the introduction of the blood serum of an actively immunized animal. 230 IMMUNITY Immunity present in an animal and not due to human interference is to be regarded as natural immunity, while if brought about by man’s effort it is considered artificial. Those cases of natural immunity mentioned above which are common to divisions, classes, orders, families, species or races of organisms and to those few individuals where no special cause is discoverable, must be regarded as instances of true inheritance through the germ cell as other char- acteristics are. All other kinds of immunity are acquired. Occasionally young are born with every evidence that they have had a disease in utero and are thereafter as immune as though the attack had occurred after birth (“smallpox babies,” “hog-cholera pigs’). Experiment has shown that immune substances may pass from the blood of the mother to the fetus in utero and the young be immune for a time after birth (tetanus). It is a familiar fact that with most infectious diseases recovery from one attack confers a more or less lasting immunity, though there are marked excep- tions. Active Immunity—By active immunity is meant that which is due to the actual introduction of the organism, or in some cases of its products. The term active is used because the body cells of the animal immunized perform the real work of bringing about the immunity as will be discussed later. In passive immunity the blood serum of an actively immunized animal is introduced into a second animal, which thereupon becomes immune, though its cells are not concerned in the process. The animal is passive, just as a test-tube, in which a reaction takes place, plays no other part than that of a passive container for the reagents. In active immunity the organism may be introduced in what is to be considered a natural manner, as when an ani- mal becomes infected, has a disease, without human inter- ference. Or the organism may be purposely introduced to bring about the immunity. For certain purposes the intro- duction of the products of the organism (toxins) is used to bring about active immunity (preparation of diphtheria and tetanus antitoxin from the horse). The method of produc- ing active immunity by the artificial introduction of the ACTIVE IMMUNITY 231 organism is called vaccination, and a vaccine must therefore contain the organism. Vaccines for bacterial diseases are frequently called bacterins. The use of the blood serum of an immunized animal to confer passive immunity on a second animal is properly called serum therapy, and the serum so used is spoken of as an antiserum, though the latter word is also used to denote any serum containing any kind of an antibody (Chapters XXVII-XXXI). Ina few instances both the organism and an antiserum are used to cause both active and passive immunity (serwm-simultanecus method in immunizing against hog cholera). In producing active immunity the organism may be intro- duced (a) alive and virulent, but in very small doses, or in combination with an immune serum, as just mentioned for hog cholera. The introduction of the live virulent organism alone is done only experimentally as yet, as it is obviously too dangerous to do in practice, except under the strictest control (introduction of a single tubercle bacillus, followed by gradually increasing numbers—Barber and Webb). More commonly the organisms are introduced (b) alive but with their wrulence reduced (“attenuated’’) in one of several ways: (1) By passing the organism through another animal as is the case with smallpox vaccine derived from a calf or heifer. (2) By drying the organism, as is done in the preparation of the vaccine for the Pasteur treatment of rabies, where the spinal cords of rabbits are dried for varying lengths of time— one to four days, Russian method, one to three days, German method, longer in this country. (It is probable that the passage of the “fixed virus” through the rabbit is as impor- tant in this procedure as the drying, since it is doubtful if the “fixed virus” is pathogenic for man.) (3) The organism may be attenuated by growing at a temperature above the normal. This is the method used in preparing anthrax vac- cine as done by Pasteur originally. (4) Instead of growing at a higher temperature the culture may be heated in such a way that it is not killed but merely weakened. Black-leg vaccines are made by this method. (5) Chemicals are some- times added to attenuate the organisms, as was formerly done in the preparation of black-leg vaccine by Kruse’s 232 IMMUNITY method in Germany. This method is no longer used to any great extent. (6) Within the past few years the workers in the Pasteur Institute in Paris have been experimenting with vaccines prepared by treating living virulent bacteria with antisera (“sensitizing them’’) so that they are no longer capable of causing the disease when introduced, but do cause the production of an active immunity. The method has been used with typhoid fever bacilli in man and seems to be successful. It remains to be tried out further before its worth is demonstrated (the procedure is more compli- cated and the chance for infection apparently much greater than by the use of killed ¢ultures). (7) Growing on artifi- cial culture media reduces the virulence of most organisms after a longer or shorter time. This method has been tried with many organisms in the laboratory, but is not now used in practice. The difficulties are that the attenuation is very uncertain and that the organisms tend to regain their virulence when introduced into the body. In producing active immunity against many bacterial diseases the organisms are introduced (c) dead. They are killed by heat or by chemicals, or by using both methods (Chapter XXX). When the products of an organism are introduced the resulting immunity is against the products only and not against the organism. If the organism itself is introduced there results an immunity against it and in some cases also against the products, though the latter does not necessarily follow. Hence the immunity may be antzbacterial or anti- toxic or both. Investigation as to the causes of immunity and the various methods by which it is produced has not resulted in the dis- covery of specific methods of treatment for as many dis- eases as was hoped for at one time. Just at present progress in serum therapy appears to be at a standstill, though vac- cines are giving good results in many instances not believed possible a few years ago. As a consequence workers in all parts of the world are giving more and more attention to the search for specific chemical substances, which will destroy invading parasites and not injure the host (Chemotherapy). ACTIVE IMMUNITY 233 Nevertheless, in the study of immunity very much of value in the treatment and prevention of disease has been learned. Also much knowledge which is of the greatest use in other lines has been accumulated. Methods of diagnosis of great exactness have resulted, applicable in numerous diseases. Ways of detecting adulterations in foods, particularly foods from animal sources, and of differentiating proteins of varied origin, as well as means of establishing biological relation- ships and differences among groups of animals through “immunity reactions” of blood serums have followed from knowledge gained by application of the facts or the methods of immunity research. Hence the study of “immunity problems” has come to include much more than merely the study of those factors which prevent the development of disease in an animal or result in its spontaneous recovery. A proper understanding of the principles of immunity neces- sitates a study of these various features and they will be considered in the discussion to follow. CHAPTER XXVI. THEORIES OF IMMUNITY. Pasteur and the bacteriologists of his time discovered that bacteria cease to grow in artificial culture media after a time, because of the exhaustion of the food material in some cases and because of the injurious action of their own products in other instances. These facts were brought for- ward to explain immunity shortly after bacteria were shown to be the cause of certain diseases. Theories based on these observations were called (1) ‘‘Exhaustion Theory” of Pasteur, and (2) “ Noxious Retention Theory” of Chauveau respec- tively. The fact, soon discovered, that virulent pathogenic bacteria are not uncommonly present in perfectly healthy animals, and the later discovery that immunity may be conferred by the injection of dead bacteria have led to the abandonment of both these older ideas. The (3) “ Unfavor- able Environment” theory of Baumgartner, 1. e., bacteria do not grow in the body and produce disease because their surroundings are not suitable, in a sense, covers the whole ground, though it is not true as to the first part, as was pointed out above, and is of no value as a working basis, since it offers no explanation as to what the factors are that constitute the “unfavorable environment.” Metchnikoff brought forward a rational explanation of immunity with his (4) “Cellular or Phagocytosis Theory.” As first pro- pounded it based immunity on the observed fact that cer- tain white blood corpuscles, phagocytes, engulf and destroy bacteria. Metchnikoff has since elaborated the original theory to explain facts of later discovery. Ehrlich soon after published his (5) “Chemical or Side-chain Theory’? which seeks to explain immunity on the basis of chemical substances in the body which may in part destroy pathogenic organ- isms or in part neutralize their products; or in some instances PAUL EHRLICH THEORIES OF IMMUNITY 235 there may be an absence of certain chemical substances in the body cells so that bacteria or their products cannot unite with the cells and hence can do no damage. At the present time it is generally accepted, in this coun- try at least, that Ehrlich’s theory explains immunity in many diseases as well as many of the phenomena related to immunity, and in other diseases the phagocytes, frequently assisted by-chemical substances, are the chief factors. Spe- cific instances are discussed in Pathogenic Bacteriologies which should be consulted. It is essential that the student should be familiar with the basic ideas of the chemical theory, not only from the standpoint of immunity, but also in order to understand the principles of a number of valuable methods of diagnosis. The chemical theory rests on three fundamental physi- ological principles: (1) the response of cells to stimuli, in this connection specific chemical stimuli, (2) the presence within cells of specific chemical groups which combine with chemi- cal stimuli and thus enable them to act on the cell, which groups Ehrlich has named receptors, and (3) the “over- production” activity of cells as announced by Weigert. 1. That cells respond to stimuli is fundamental in physi- ology. These stimuli may be of many kinds as mechanical, electrical, light, chemical, etc. Chemical stimuli are well illustrated along the digestive tract. That the chemical stimuli in digestion may be more or less specific is shown by the observed differences in the enzymes of the pancreatic juice dependent on the relative amounts of carbohydrates, fats, or proteins in the food, the specific enzyme in each case being increased in the juice with increase of its corresponding foodstuff. The cells of the body, or certain of them at least, seem to respond in a specific way when proteins or substances closely related to them are brought into direct contact with them, that is, without having been subjected to digestion in the alimentary tract, but injected directly into the blood or lymph stream. Cells may be affected by stimuli in one of three ways: if the stimulus is too weak, there is no effect (in reality there is no “stimulus” acting); if the stimulus is too strong, the cell is injured, may be 236 THEORIES OF IMMUNITY destroyed; if the stimulus is of proper amount then it excites the cell to increased activity, and in the case of specific chemical stimuli the increased activity, as mentioned for the pancreas, shows itself in an increased production of what- ever is called forth by the chemical stimulus. In the case of the proteins and related bodies, the substances produced by the cells under their direct stimulation are markedly specific for the particular substance introduced. 2. Since chemical action always implies at least two bodies to react, Ehrlich assumes that in every cell which is affected by a chemical stimulus there must therefore be a chemical group to unite with this stimulus. He further states that there must be as many different kinds of these groups as there are different kinds of chemicals which stimu- late the cell. Since these groups are present in the body cells primarily to take up different kinds of food material, Ehrlich calls them receptors. Since these groups must be small as compared with the cell as a whole, and must be more or less on the surface and unite readily with chemical substances he further speaks of them as “side-chains’’ after the analogy of compounds of the aromatic series especially. The term receptors is now generally used. As was stated above, the effect of specific chemical stimuli is to cause the production of more of the particular substance for which it is specific and in the class of bodies under discussion, proteins and their allies, the particular product is these cell receptors with which the chemical may unite. 3. Weigert first called attention to the practically con- stant phenomenon that cells ordinarily respond by doing more of a particular response than is ctually called for by the stimulus, that there is always an “overproduction” of activity. In the case of chemical stimuli this means an increased production of the specific substance over and above the amount actually needed. Whenever a cell accumulates an excess of products the normal result is that it excretes them from its own substance into the surrounding lymph, whence they reach the blood stream to be either carried to the true excretory organs, utilized by other cells or remain for a longer or shorter time in the blood. THEORIES OF IMMUNITY 237 To recapitulate, Ehrlich’s theory postulates specific chema- cal stimuli, which react with specific chemical substances in the body cells, named receptors, and that these receptors, according to Weigert, are produced in excess and hence are excreted from the cell and become free receptors in the blood ‘and lymph. These free receptors are the various kinds of antibodies, the kind depending on the nature of the stimulus, the substance introduced. Any substance which when introduced into the body causes the formation of an anti- body of any kind whatsoever is called an antigen, 2. ¢., anti (body) former. If the three fundamental principles just discussed are thoroughly understood, the theory of the formation of different kinds of antibodies should not be difficult to comprehend. CHAPTER XXVII. RECEPTORS OF THE FIRST ORDER. ANTITOXINS— ANTIENZYMES. THE general characteristics of toxins have been described (Chapter XII). It has been stated that they are more or less specific in their action on cells. In order to affect a cell it is evident that a toxin must enter into chemical combina- tion with it. This implies that the toxin molecule possesses a chemical group which can combine with the cell. This group is called the haptophore or combining group. The toxic or injurious portion of the toxin molecule is likewise spoken of as the torophore group. When a toxin is intro-: duced into the body its haptophore group combines with suitable receptors in different cells of the body. If not too much of the toxin is given, instead of injuring, it acts as a chemical stimulus to the cell in the manner already described. The cell in response produces more of the specific thing, which in this instance is more receptors which can combine with the toxin, 7. e., with its haptophore group. If the stim- ulus is kept up, more and more of these receptors are pro- duced until an excess for the cell accumulates, which excess is excreted from the individual cell and becomes free in the blood. These free receptors have, of course, the capacity to combine with toxin through its haptophore group. When the toxin is combined with these free receptors, it cannot combine with any other receptors, e. g., those in another cell and hence cannot injure another cell. These free recep- tors constitute, in this case, antitowin, so-called because they can combine with toxin and hence neutralize it. Antitoxins are specific—that is, an antitoxin which will combine with the toxin of Bacillus tetant will not combine with that of Bacterium diphtherie, or of Bacillus botulinus, or of any other toxin, vegetable or animal. ANTITOXINS—ANTIENZY MES 239 When a toxin is kept in solution for some time or when it is heated above a certain temperature (different for each toxin) it loses its poisonous character. It may be shown, however, that it is still capable of uniting with 'antitoxin, and preventing the latter from uniting with a fresh toxin. This confirms the hypothesis that a toxin molecule has at least two groups: a combining or haptophore, and a poison- ing or torophore group. A toxin which has lost its poisonous property, its toxophore group, is spoken of as a toroid. The theory of antitoxin formation is further supported by the fact that the proper introduction of toxoid, the haptophore group, and hence the real stimulus, can cause the production of antitoxin to a certain extent at least. The close relationship between toxins and enzymes has already been pointed out. This is still further illustrated by the fact that when enzymes are properly introduced into the tissues of an animal there is formed in the animal an antienzyme specific for the enzyme in question which can prevent its action. The structure of enzymes, as composed of a haptophore, or uniting, and a zymophore or digesting (or other activity) group, is similar to that of toxins, and enzymoids or enzymes which can combine with the substance acted on but not affect it further have been demonstrated. These free-cell receptors, antitoxins or antienzymes, which are produced in the body by the proper introduction of toxins or enzymes, respectively, have the function of com- bining with these bodies but no other action. As was pointed out above, this is sufficient to neutralize the toxin or enzyme and prevent any injurious effect since they can unite with nothing else. Since these receptors are the simplest type which has been studied as yet, they are spoken of by Ehrlich as receptors of the first order. Other antibodies which are likewise free receptors of the first order and have the func- tion of combining only have been prepared and will be referred to in their proper connection. They are mainly of theoretical interest. Ehrlich did a large part of his work on toxins and anti- toxins with ricin, the toxin of the castor-oil bean, abrin, from the jequirity bean, robin from the locust tree, and with 240 RECEPTORS OF THE FIRST ORDER the toxins and antitoxins for diphtheria and tetanus. Anti- toxins have been prepared experimentally for a large number of both animal and vegetable poisons, including a number for bacterial toxins. The only ones which, as yet, are of much practical importance are antivenin for snake poison, (not a true toxin, however, see p. 252), antipollenin (sup- posed to be for the toxin of hay fever) and the antitoxins for the true bacterial toxins of Bacterium diphtherie and Bacillus tetani. The method of preparing antitoxins is essentially the same in all cases, though differing in minor details. For commer- cial purposes large animals are selected, usually horses, so that the yield of serum may be large. The animals must, of course, be vigorous, free from all infectious disease. The first injection given is either a relatively small amount of a solution of toxin or of a mixture of toxin and antitoxin. The animal shows more or less reaction, increased temper- ature, pulse and respiration and frequently an edema at the point of injection, unless this is made intravenously. After several days to a week or more, when the animal has recov- ered from the first injection, a second stronger dose is given, usually with less reaction. Increasingly large doses are given at proper intervals until the animal may take several hundred times the amount which would have been fatal if given at first. The process of immunizing a horse for diph- theria or tetanus toxin usually takes several months. Varia- tions in time and in yield of antitoxin are individual and not predictable in any given case. After several injections a few hundred cubic centimeters of blood are withdrawn from the jugular vein and serum from this is tested for the amount of antitoxin it contains. When the amount is found sufficiently large (250 “units” at least for diphtheria per c.c.) then the maximum amount of blood is collected from the jugular with sterile trocar and canula. The serum from this blood with the addition of an antiseptic (0.5 per cent. phenol, tricresol, etc.) constitutes ‘“‘antidiphtheritic serum,” or “antitetanic serum,” etc. All sera which are put on the market must conform to definite standards of strength expressed in “units” as determined ANTITOXINS—ANTIENZY MES 241 by the U. S. Hygienic Laboratory. In reality a “unit” of diphtheria antitoxin in the United States is an amount equivalent to 1 c.c. of a given solution of a standard diph- theria antitorin which is kept at the above-mentioned laboratory. This statement, of course, gives no definite idea as to the amount of antitoxin actually in a “unit.” Specifi- cally stated, a “unit” of antitoxin contains approximately the amount which would protect a 250-gram guinea-pig from 100 minimum lethal doses of diphtheria toxin, or protect 100 guinea-pigs weighing 250 grams each from one minimum lethal dose each. The minimum lethal dose (M. L. D.) of diphtheria toxin is the least amount that will kill a guinea- pig of the size mentioned within four days. Since toxins on standing change into toxoids to a great extent, the amount of antitoxin in a “unit,” though protecting against 100 M.L. D., in reality would protect against about 200 M. L. D. of toxin containing no toxoid. The official unit for tetanus antitoxin is somewhat dif- ferent, since it is standardized against a standard toxin which is likewise kept at the Hygienic Laboratory. The unit is defined as ‘“‘ten times the amount of antitoxin necessary to protect a 350 gm. guinea-pig for 96 hours against the standard test dose’’ of the standard toxin. The standard test dose is 100 M. L. D. of toxin for a 350 gm. guinea-pig. To express it another way, one could say that a “unit” of tetanus anti- toxin would protect one thousand 350 gm. guinea-pigs from 1M. L. D. each of standard tetanus toxin. Various methods have been devised for increasing the amount of antitoxin in 1 c.c. of solution by precipitating out portions of the blood-serum proteins and at the same time concentrating the antitoxin in smaller volume. It is not considered necessary in a work of this character to enter into these details nor to discuss the process of standardizing antitoxin so that the exact content of “units” per c.c, may be known. 16 CHAPTER XXVIII. RECEPTORS OF THE SECOND ORDER. AGGLUTININS. CHARRIN and Rogers appear to have been the first (1889) to observe the clumping together of bacteria (Pseudomonas pyocyanea) when mixed with the blood serum of an animal immunized against them. Gruber and Durham (1896) first used the term “agglutination” in this connection and called the substance in the blood-serum “agglutinin.” Widal (1896) showed the importance of the reaction for diagnosis by testing the blood serum of an infected person against a known culture (typhoid fever). It is now a well-known phenomenon that the proper injec- tion of cells of any kind foreign to a given animal will lead to the accumulation in the animal’s blood of substances which will cause a clumping together of the cells used when suspended in a suitable liquid. The cells settle out of such suspension much more rapidly than they would otherwise do. This clumping is spoken of as “agglutination’’ and the substances produced in the animal are called ‘ agglutinins.” If blood cells are injected then “hemagglutinins”’ result; if bacterial cells “bacterial agglutinins” for the particular organism used as “glanders agglutinin” for Bacterium mallet, “abortion agglutinin” for Bacterium abortus, “typhoid agglutinin” for Bacillus typhosus, etc. The phenomenon may be observed either under the micro- scope or in small test-tubes, that is, either microscopically or macroscopically. Tn this case the cells introduced, or more properly, some substances within the cells, probably protein in nature, act as stimuli to the body cells of the animal injected to cause them to produce more of the specific cell receptors which AGGLUTININS 243 respond to the stimulus. The substance within the intro- duced cell which acts as a stimulus (antigen) to the body cells is called an “agglutinogen.” That ‘“‘agglutinogen’’ is present in the cell has been shown by injecting animals exper- imentally with extracts of cells (bacterial and other cells) and the blood serum of the animal injected showed the presence of agglutinin for the given cell. It will be noticed that the receptors which become the free agglutinins have at least two functions, hence at least two chemical groups. They must combine with the foreign cells and also bring about their clumping together, their agglutination. Hence it can be stated technically that an agglutinin possesses a haptophore group, and an agglutinating group. The formation of agglutinin in the body for different bac- teria doés not as yet appear to be of any special significance in protecting the animal from-the organism, since the bac- teria are not killed, even though they are rendered non- motile, if of the class provided with flagella, and are clumped together. The fact that such bodies are formed, however, is of decided value in the diagnosis of disease, and also in the identification of unknown bacteria. In many bacterial diseases, agglutinins for the particular organism are present in the blood serum of the affected animal. Consequently if the blood serum of the animal be mixed with a suspension of the organism supposed to be the cause of the disease and the latter be agglutinated, one is justified in considering it the causative agent, provided cer- tain necessary conditions are fulfilled. In the first place it must be remembered that the blood of normal animals fre- quently contains agglutinins (‘normal agglutinins’) for many different bacteria when mixed with them in full strength. Hence the serum must always be diluted with physiological salt solution (0.85 per cent.). Further, closely related bacteria may be agglutinated to some extent by the same serum. It is evident that if they are closely related, their protoplasm must contain some substances of the same kind to account for this relationship. Since some of these substances may be agglutinogens, their introduction into the animal body will give rise to agglutinins for the related 244 RECEPTORS OF THE SECOND ORDER cells, as well as for the cell introduced. The agglu- tinins for the cell introduced will be formed in larger quan- tity, since a given bacterial cell must contain more of its own agglutinogen than that of any other cell. By diluting the blood serum from the animal to be tested the agglutinins for the related organisms (so-called ‘‘coagglutinins’”) will become so much diminished as to show no action, while the agglutinin for the specific organism is still present in an amount sufficient to cause its clumping. Agglutinins are specific for their particular agglutinogens, but since a given blood serum may contain many agglutinins, the serwm’s specificity for a given bacterium can be determined only by diluting it until this bacterium alone is agglutinated. Hence the necessity of diluting the unknown serum in varying amounts when testing against several known bacteria to determine for which it is specific, 7. e., which is the cause of the disease in the animal. Just as an unidentified disease in an animal may be deter- mined by testing its serum as above described against known kinds of bacteria, so unknown bacteria isolated from an animal, from water, etc., may be identified by testing them against the blood sera of different animals, each of which has been properly inoculated with a different kind of known bac- teria. If the unknown organism is agglutinated by the blood of one of the animals in high dilution, and not by the others, evidently the bacterium is the same as that with which the animal had been inoculated, or immunized, as is usually stated. This method of identifying cultures of bacteria is of wide application, but is used practically only in those cases where other methods of identification are not readily applied, and especially where other methods are not sufficient, as in the “intestinal group” of organisms in human practice. The diagnosis of disease in an animal by testing its serum is also a valuable and much used procedure. This is the method of the “ Widal’” or “Gruber-Widal” test for typhoid fever in man and is used in veterinary practice in testing for glanders, contagious abortion, etc. In some cases a dilu- tion of the serum of from 20 to 50 times is sufficient for PRECIPITINS 245 diagnosis (Malta fever), in most cases, however, 50 times is the lowest limit. Evidently the greater the dilution, that is, the higher the “titer,” the more specific is the reaction. PRECIPITINS. Since agglutinins act on bacteria, probably through the presence of substances protein in nature within the bacterial cell, it is reasonable to expect that if these substances be dissolved out of the cell, there would be some reaction between their (colloidal) solution and the same serum. As a matter of fact Kraus (1897) showed that broth cultures freed from bacteria by porcelain filters do show a precipi- tate when mixed with the serum of an animal immunized against the particular bacterium and that the reaction is specific under proper conditions of dilution. It was not long after Kraus’s work until the experiments were tried of “immunizing” an animal not against a bacterium or its filtered culture, but against (colloidal) solutions of proteins, such as white of egg, casein of milk, proteins of meat and of blood serum, vegetable proteins, etc. It was ascertained that in all these cases the animal’s serum contains a sub- stance which causes a precipitate with solutions of the pro- tein used for immunization. The number of such precipi- tating serums that have been made experimentally is very large and it appears that protein from any source when properly introduced into the blood or tissues of an animal will cause the formation of a precipitating substance for its solutions. This substance is known, technically as a “orecipitin.” The protein used as antigen to stimulate its formation, or some part of the protein molecule (hapto- phore group), which acts as stimulus to the cell is spoken of as a “precipitinogen,” both terms after the analogy of “agelutinin” and “agglutinogen.”’ In fact the specific pre- cipitation and agglutination are strictly analogous phenom- ena. Precipitins act on proteins in (colloidal) solution and cause them to settle out, agglutinins act on proteins within cells which cells are in suspension in a fluid and cause the cells to settle out. Ehrlich’s theory of the formation of \ 246 RECEPTORS OF THE SECOND ORDER precipitins is similar to that of agglutinins, and need not be repeated. Substitute the corresponding words in the theory of formation of agglutinins as above given and the theory applies. The precipitin reaction has not found much practical use in bacteriology largely because the “agglutination test”’ takes its place as simpler of performance and just as ac- curate. The reaction is, however, generally applicable to filtrates of bacterial cultures and could be used if needed. The so-called “mallease”’ reaction in glanders is an instance. Precipitins find their greatest usefulness in legal medi- cine and in food adulteration work. As was noted above, if animals, rabbits for example, are immunized with the blood of another animal (human beings) precipitins are developed which are specific for the injected blood with proper dilution. This forms an extremely valuable means of determining the kind of blood present in a given spot shown by chemical and spectroscopic tests to be blood, and has been adopted as a legal test in countries where such rules of procedure are applied. Similarly the test has been used to identify the different kinds of meat in a sausage, and different kinds of milk in a mixture. An extract of the sausage is made and tested against the serum of an animal previously treated with extract of horse meat, or hog meat, or beef, etc., the specific precipitate occurring with the specific serum. Such reactions have been obtained where the protein to be tested was diluted 100,000 times and more. Biological relationships and differences have been detected by the reaction. Human immune serum shows no reaction with the blood of any animals except to a slight extent with that of various monkeys, most with the higher, very slight with the lower Old World and scarcely any with New World monkeys. It is a fact of theoretical interest mainly that if agglutinins and precipitins themselves be injected into an animal they will act as antigens and cause the formation of antiagglu- tinins or antiprecipitins, which are therefore receptors of the first order since they simply combine with these immune bodies to neutralize their action, have only a combining or PRECIPITINS 247 haptophore group. Also if agglutinins or precipitins be heated to the proper temperature they may retain their combining power but cause no agglutination or precipita- tion, 7. e., they are converted into agglutinoid or precipi- tinoid respectively after the analogy of toxin and toxoid. Precipitins like agglutinins possess at least two groups— a combining or haptophore group and a precipitating (some- ‘times called zymophore) group. Hence they are somewhat more complex than antitoxins or antienzymes which have a combining group only. For this reason Ehrlich classes agglutinins and precipitins as receptors of the second order. CHAPTER XXIX. RECEPTORS OF THE THIRD ORDER. CYTOLYSINS. Berore Koch definitely proved bacteria capable of caus- ing disease several physiologists had noted that the red cor- puscles of certain animals were destroyed by the blood of other animals (Creite, 1869, Landois, 1875), and Traube and Gescheidel had shown that freshly drawn blood destroys bacteria (1874). It was not until about ten years afterward that this action of the blood began to be investigated in connection with the subject of immunity. Von Fodor (1885) showed that saprophytic bacteria injected into the blood are rapidly destroyed. Fliigge and his pupils, especially Nuttall in combating Metchnikoff’s theory of phago- cytosis, announced in 1883, studied the action of the blood on bacteria and showed its destructive effect (1885-87). Nuttall also showed that the blood lost this power if heated to 56°. Buchner (1889) gave the name “‘alexin’”’ (from the Greek ‘‘to ward off’) to the destroying substance and showed that the substance was present in the blood serum as well as in the whole blood, and that when the serum lost its power to dissolve, this could be restored by adding fresh blood. Pfeiffer (1894) showed that the destructive power of the blood of animals immunized against bacteria (cholera and typhoid) was markedly specific for the bacteria used. He introduced a mixture of the blood and the bacteria into the abdominal cavity of the immunized animal or of a normal one of the same species and noted the rapid solution of the bacteria by withdrawing portions of the peritoneal fluid and exam- ining them (“‘Pfeiffer’s phenomenon’’). Belfanti and Car- bone and especially Bordet (1898) showed the specific dis- solving action of the serum of one animal on the blood cor- CYTOLYSINS 249 puscles of another animal with which it had been injected. Since this time the phenomenon has been observed with a great variety of cells other than red blood corpuscles and bacteria—leukocytes, spermatozoa, cells from liver, kidney, brain, epithelia, etc., protozoa, and many vegetable cells. It is therefore a well-established fact that the proper injection of an animal with almost any cell foreign to it will lead to the blood of the animal injected acquiring the power to injure or destroy cells of the same kind as those introduced. The destroying power of the blood has been variously called its “cytotoxic” or “cytolytic” power, though the terms are not strictly synonymous since “cytotoxic’’ means ‘cell poisoning” or “injuring,” while “cytolytic” means “cell dissolving.” The latter term is the one gen- erally used and there is said to be present in the blood a specific “cytolysin.” The term is a general one and a given cytolysin is named from the cell which is dissolved, as a bactertolysin, a hemolysin (red-corpuscle-lysin), epitheliolysin, nephrolysin (for kidney cells), etc. If the cell is killed but not dissolved the suffix “cidin” or “toxin” is frequently used s “bacteriocidin,” “spermotoxin,” “neurotoxin,” etc. The use of the term “cytolysin” is also not strictly ‘cor- ‘rect, though convenient, for the process is more complex than if one substance only were employed. As was stated above, the immune serum loses its power to dissolve the cell if it is heated to 55° to 56° for half an hour, it is inactivated. But if there be added to the heated or inactivated serum a small amount of normal serum (which contains only a very little cytolytic substance, so that it has no dissolving power when so diluted) then the mixture again becomes cytolytic. It is evident then that in cytolysis there are two distinct substances involved, one which is present in all serum, normal or immune, and the other present only in the immune cytolytic serum. Experiment has shown that it is the substance present in all serum that is the true dissolving body, while the immune substance serves merely to unite this body to the cell to be destroyed, 7. e., to the antigen. Since the immune body has therefore two uniting groups, one for the dissolv- ing substance and one for the cell to be dissolved, Ehrlich 250 RECEPTORS OF THE THIRD ORDER calls it the “amboceptor.” He also uses the word “comple- ment’ to denote the dissolving substance, giving the idea that it completes the action of dissolving after it has been united to the cell by the amboceptor, thus replacing Buchner’s older term “alexin” for the same dissolving body. AMBOCEPTORS. The theory of formation of amboceptors is similar to that for the formation of the other types of antibodies. The cell introduced contains some substance, probably protein, which acts as a chemical stimulus to some of the body cells provided with proper receptors so that more of these special receptors are produced, and eventually in excess so that they become free in the blood and constitute the free ambocep- tors. It will be noticed that these free receptors differ from either of the two groups already described in that they have two uniting growps, one for the antigen (cell introduced) named cytophil haptophore, the other for the complement, complementophil haptophore. Hence amboceptors are spoken of as receptors of the third order. They have no other func- tion than that of this double combining power. The action which results is due to the third body—the complement. It will be readily seen that complement must possess at least two groups, a combining or haptophore group which unites with the amboceptor, and an active group which is usually called the zymophore or toxophore group. Comple- ments thus resemble either toxins, where the specific cell (antigen) is injured or killed, or enzymes, in case the cell is likewise dissolved. This action again shows the close rela- tion between toxins and enzymes. Complement may lose its active group in the same way that toxin does and becomes then complementoid. Complement is readily destroyed in blood or serum by heating it to 55° to 56° for half an hour, and is also destroyed spontaneously when serum stands for a day or two, less rapidly at low temperature than at room temperature. Amboceptors appear to be specific in the same sense that agglutinins are. That is, if a given cell is used to immunize COMPLEMENTS 251 an animal, the animal’s blood will contain amboceptors for the cell used and also for others closely related to it. Immun- ization with spermatozoa or with epithelial or liver cells gives rise to amboceptors for these cells and also for red blood corpuscles and other body cells. A typhoid bactericidal serum has also some dissolving effect on colon bacilli, etc. Hence a given serum may contain a chief amboceptor and a variety of “coamboceptors,”’ or one amboceptor made up of a number of “partial amboceptors” each specific for its own antigen (“‘amboceptorogen”). Amboceptors may com- bine with other substances than antigen and complement, as is shown by their union with lecithin and other “‘lipoids,” though these substances seem capable of acting as comple- ment in causing solution of blood corpuscles. ~ COMPLEMENTS. As to whether complements are numerous, as Ehrlich claims, or there is only one complement, according to Buch- ner and others, need not be discussed here. In the practi- cal applications given later as means of diagnosis it is appar- ent that all the complement or complements are capable of uniting with at least two kinds of amboceptors. If complement be injected into an animal it may act as an antigen and give rise to the formation of anticomplement which may combine with it and prevent its action and is consequently analogous to antitoxin. If amboceptors as antigen are injected into an animal there will be formed by the animal’s cells antiamboceptors. As one would expect, there are two kinds of antiamboceptors, one for each of its combining groups, since it has been stated that it is always the combining group of any given antigen that acts as the cell stimulus. Hence we may have an ‘“‘anticytophil ambo- ceptor” or an “anticomplementophil amboceptor.” These antiamboceptors and the anticomplements are analogous to antitoxin, antiagglutinin, etc., and hence are receptors of the first order. 252 RECEPTORS OF THE THIRD ORDER ANTISNAKE VENOMS. A practical use of antiamboceptors is in antisnake venoms, Snake poisons appear to contain only amboceptors for differ- ent cells of the body. In the most deadly the amboceptor is specific for nerve cells (cobra), in others for red corpuscles, or for endothelial cells of the bloodvessels (rattlesnake). The complement is furnished by the blood of the individual bitten, that is, in a sense the individual poisons himself, since he furnishes the destroying element. The antisera contain antiamboceptors which unite with the amboceptor introduced and prevent it joining to cells and thus binding the complement to the cells and destroying them. With this exception these antibodies are chiefly of theoretical interest. FAILURE OF CYTOLYTIC SERUMS. The discovery of the possibility of producing a strongly bactericidal serum in the manner above described aroused the hope that such sera would prove of great value in passive immunization and serum treatment of bacterial diseases. Unfortunately such expectations have not been realized and no serum of this character of much practical importance has been developed as yet (with the possible exception of Flex- ner’s antimeningococcus serum in human practice. What hog cholera serum is remains to be discovered). The reasons for the failure of such sera are not entirely clear. The following are some that have been offered: (1) Amboceptors do not appear to be present in very large amount so that relatively large injections of blood are neces- sary, which is not without risk in itself. (2) Since the com- plement is furnished by the blood of the animal to be treated, there may not be enough of this to unite with a sufficient quantity of amboceptor to destroy all the bacteria present, hence the disease is continued by those that escape. (3) Or the complement may not be of the right kind to unite with the amboceptor introduced, since this is derived from the blood of a heterologous (“other kind’’) species. In hog- cholera serum, if it is bactericidal, this difficulty is removed COMPLEMENT-FIXATION TEST 253 by using blood of an homologous (“same kind’’) animal. Hence Ehrlich suggested the use of apes for preparing bac- tericidal sera for human beings. (4) The bacteria may be localized in tissues (lymph glands), within cavities (cranial, peritoneal), in hollow organs (alimentary tract), etc., so that it is not possible to get at them with sufficient serum to destroy all. This difficulty is obviated by injecting directly into the spinal canal when Flexner’s antimeningococcus serum is used. (5) Even if the bacteria are dissolved it does not necessarily follow that their endotorins are destroyed. These may be merely liberated and add to the danger of the patient, though this does not appear to be a valid objec- tion. (6) Complement which is present in such a large excess of amboceptor may just as well unite with amboceptor which is not united to the bacteria to be destroyed as with that which is, and hence be actually prevented from dissolv- ing the bacteria. Therefore it is difficult to standardize the serum to get a proper amount of amboceptor for the com- plement present. COMPLEMENT-FIXATION TEST. Although little practical use has been made of bactericidal sera, the discovery of receptors of this class and the peculiar relations between the antigen, amboceptor and complement have resulted in developing one of the most delicate and accurate methods for the diagnosis of disease and for the recognition of small amounts of specific protein that is in use today. This method is usually spoken of as the “ complement-fixa- tion” or the ‘“complement-deviation test” (‘“Wassermann test” in syphilis) and is applicable in a great variety of mi- crobial diseases, but it is of practical importance in those diseases only where other methods are uncertain—syphilis in man, concealed glanders in horses, contagious abortion in cattle, etc. The principle is the same in all cases. The method depends, as indicated above, on the ability of complement to combine with at least two amboceptor-antigen systems, ? 254 RECEPTORS OF THE THIRD ORDER and on the further fact that if the combination with one amboceptor-antigen system is once formed, it does not dis- sociate so as to liberate the complement for union with the second amboceptor-antigen system. If an animal is infected. with a microérganism and a part of its defensive action con- sists in destroying the organisms in its blood or lymph, then it follows from the above discussion of cytolysins that there will be developed in the blood of the animal amboceptor specific for the organism in question. If the presence of this specific amboceptor can be detected, the conclusion is war-. ranted that the organism for which it is specific is the cause of the disease. Consequently what is sought in the “com- plement-fixation test’ is a specific amboceptor. In carrying out the test blood serum from the suspected animal is col- lected, heated at 56° for half an hour to destroy any comple- ment it contains and mixed in definite proportions with the specific antigen and with complement. The antigen is an extract of a diseased organ (syphilitic fetal liver, in syphilis), a suspension of the known bacteria, or an extract of these bacteria. Complement is usually derived from a guinea- pig, since the serum of this animal is higher in complement than that of most animals. The blood of the gray rat con- tains practically as much. If the specific amboceptor is present, that is, if the animal is infected with the suspected disease, the complement will unite with the antigen-ambo- ceptor system and be “‘fixed,”’ that is, be no longer capable of uniting with any other amboceptor-antigen system. No chemical or physical means of telling whether this union has occurred or not, except as given below, has been discovered as yet, though doubtless will be by physicochemical tests, nor can the combination be seen. Hence an “indicator,” as is so frequently used in chemistry, is put into the mixture of antigen-amboceptor complement after it has been allowed to stand in the incubator for one hour to permit the union to become complete. The “indicator” used is a mixture of sheep’s corpuscles and the heated (“inactivated”) blood serum of a rabbit which has been injected with sheep’s blood corpuscles and therefore contains a hemolytic ambo- ceptor specific for the corpuscles, which is capable also of COMPLEMENT-FIXATION TEST 255 uniting with complement. The indicator is put into the first mixture and the whole is again incubated for at least two hours and examined. If the mixture is clear and color- less with a deposit of red corpuscles at the bottom, that would mean that the complement had been bound to the first complex, since it was not free to unite with the second sheep’s corpuscles (antigen)—rabbit serum (hemolytic ambo- ceptor) complex—and destroy the corpuscles. Hence if the complement is bound in the first instance, the specific ambo- ceptor for the first antigen must have been present in the blood, that is, the animal was infected with the organism in question. Such a reaction is called a “positive” test. On the other hand, if the final solution is clear but of a red color, that would mean that complement must have united with the corpuscles—hemolytic amboceptor system—and destroyed the corpuscles in order to cause the clear red solution of hemoglobin. If complement united with this system it could not have united with the first system, hence there was no specific amboceptor there to bind it; no specific amboceptor in the animal’s blood, means no infection. Hence a red solution is a ‘‘negative test.” In practice all the different ingredients must be accurately tested, standardized and used in exact quantities, and a test must also be run as a control with a known normal blood ‘of an animal of the same species as the one examined. The complement-fixation test might be applied to the determination of unknown bacteria, using the unknown cul- ture as antigen and trying it with the sera of different animals’ immunized against a variety of organisms, some one of which might prove to furnish specific amboceptor for the unknown. organism and hence indicate what it is. The test used in this way has not been shown to be a practical necessity and hence is rarely employed. It has been used, however, to detect traces of unknown proteins, particularly blood-serum proteins, in medicolegal cases in exactly the above outlined manner and is very delicate and accurate. CHAPTER XXX. PHAGOCYTOSIS—OPSONINS. Ir has been mentioned that Metchnikoff, in a publication in 1883, attempted to explain immunity on a purely cellular basis. It has been known since Haeckel’s first observation in 1858 that certain of the white corpuscles do engulf solid particles that may get into the body, and among them bac- teria. Metchnikoff at first thought that this engulfing and subsequent intracellular digestion of the microdrganisms were sufficient to protect the body from infection. The later discoveries (discussed in considering Ehrlich’s theory of immunity) of substances present in the blood serum and even in the blood plasma which either destroy the bacteria or neutralize their action have caused Metchnikoff to modify his theory to a great extent. He admitted the presence of these substances, though giving them other names, but ascribed their formation to the phagocytes or to the same organs which form the leukocytes—lymphoid tissue generally, bone marrow. It is not within the province of this work to attempt to reconcile these theories, but it may be well to point out that Ehrlich’s theory is one of chemical substances and that the origin of these substances is not an essential part of the theory, so that the two theories, except in some minor details, are not necessarily mutually exclusive. Sir A. E. Wright and Douglas, in 1903, showed that even in those instances where immunity depends on phagocytosis, as it certainly does in many cases, the phagocytes are more or less inactive unless they are aided by chemical substances present in the blood. These substances act on the bacteria, not on the leukocytes, and change them in such a way that they are more readily taken up by the phagocytes. Wright proposed for these bodies the name opsonin, derived from a ELIE METCHNIKOFF PHAGOCY TOSIS—OPSONINS 257 Greek word signifying “‘to prepare a meal for.” Neufeld and Rimpau at about the same time (1904), in studying immune sera, observed substances of similar action in these sera and proposed the name bactertotropins, or bacteriotropic substances. There is scarcely a doubt that the two names are applied to identical substances and that Wright’s name opsonin should have preference. The chemical nature of opsonins is not certainly deter- mined, but they appear to be a distinct class of antibodies and to possess two groups, a combining or haptophore and a preparing or opsonic group and hence are similar to anti- bodies of Ehrlich’s second order—agglutinins and_precipi- tins. Wright also showed that opsonins are just as specific as agglutinins are—that is, a micrococcus opsonin prepares micrococci only for phagocytosis and not streptococci or any other bacteria. Wright showed that opsonins for many bacteria are present in normal serum and that in the serum of an animal which has been immunized against -such bacteria the opsonins are increased in amount. Also that in a person infected with certain bacteria the opsonins are either increased or diminished, depending on whether the progress of the infec- tion is favorable or unfavorable. The opsonic power of a serum normal or otherwise is determined by mixing an emulsion of fresh leukocytes in normal saline solution with a suspension of the bacteria and with the serum to be tested. The leukocytes must first be washed in several changes of normal salt solution to free them from any adherent plasma or serum. The mixture is incubated for about fifteen min- utes and then slides are made, stained with a good differ- ential blood stain, Wright’s or other, and the average num- ber of bacteria taken up by at least fifty phagocytes taken in order in a field is determined by counting under the microscope. The number so obtained Wright calls the phagocytic index of the serum tested. The phagocytic index of a given serum divided by the phagocytic index of a nor- mal serum gives the opsonic index of the serum tested. Assuming the normal opsonic index to be 1, Wright asserts that in healthy individuals the range should be not more 17 258 ? PH AGOCYTOSIS—OPSONINS than from 0.8 to 1.2, and that an index below 0.8 may show a great susceptibility for the organism tested, infection with the given organism if derived from the individual, or improper dosage in case attempts have been made to immunize by using killed cultures, vaccines, of the organism. On the occasion of the author’s visit to Wright’s clinic (1911) he stated that he used the determination of the opsonic index chiefly as a guide to the dosage in the use of vaccines. Most workers outside the Wright school have failed to recognize any essential value of determinations of the opsonic index in the use of vaccines. Some of the reasons for this are as follows: The limit of error in phagocytic counts may be as great as 50 per cent. in different series of fifty, hence several hundred must be counted, which adds greatly to the tediousness and time involved; the variation in apparently healthy individuals is frequently great, hence the “normal” is too uncertain; finally the opsonic index and the clinical course of the disease do not by any means run parallel. Undoubtedly the method has decided value in the hands of an individual who makes opsonic determina- tions his chief work, as Wright’s assistants do, but it can scarcely be maintained at the present time that such deter- minations are necessary in vaccine therapy. Nevertheless that opsonins actually exist and that they play an essential part in phagocytosis, and hence in immunity, is now generally recognized. BACTERIAL VACCINES. Whether determinations of opsonic index are useful or not is largely a matter of individual opinion, but there is scarcely room to doubt that Wright has conferred a lasting benefit by his revival of the use of dead cultures of bacteria, bacterial vaccines, both for protective inoculation and for treatment. It is perhaps better to use the older terms “vaccination” and “vaccine’’ (though the cow, vacca, is not concerned) than to use Wright’s term “opsonic method”’ in this connection, bearing in mind that the idea of a vaccine is that it contains the causative organism of the infection as indicated on p. 231. BACTERIAL VACCINES 259 As early as 1880 Touissant proposed the use of dead cul- tures of bacteria to produce immunity. But because injec- tions of such cultures were so frequently followed by abscess formation, doubtless due to the high temperatures used to kill the bacteria, the method was abandoned. Further, Pas- teur and the French school persistently denied the possi- bility of success with such a procedure, and some of them even maintain this attitude at the present time. The suc- cesses of Wright and the English school which are being repeated so generally wherever properly attempted, leave no doubt in the unprejudiced of the very great value of the method and have unquestionably opened a most promising field both for preventive inoculation and for treatment in many infectious diseases. That the practice is no more universally applicable than are immune serums and that it has been and is still being grossly overexploited is undoubted. The use of a vaccine is based on two fundamental prin- ciples. The first of these is that the cell introduced must not be in a condition to cause serious injury to the animal by its multiplication and consequent. elaboration of injurious sub- stances. The second is that, on the other hand, it must con- tain antigens in such condition that they will act as stimuli to the body cells to produce the necessary antibodies, whether these be opsonins, bactericidal substances, or anti- endotoxins. In the introduction of living organisms there is always more or less risk of the organism not being suffi- ciently attenuated and hence of the possibility of its pro- ducing too severe an infection. In using killed cultures, great care must be exercised in destroying the organisms, so that the antigens are not at the same time rendered inactive. Hence in the preparation of bacterial vaccines by Wright’s method the temperature and the length of time used to kill the bacteria are most important factors. This method is in gen- eral to grow the organisms on an agar medium, rub off the culture and emulsify in sterile normal salt solution (0.85 per cent. NaCl). The number of bacteria per c.c. is deter- mined by staining a slide made from a small volume of the emulsion mixed with an equal volume of human blood drawn from the finger and counting the relative number of bac- 260 PHAGOCYTOSIS—OPSONINS teria and of red blood corpuscles. Since the corpuscles are normally 5,000,000 per c.mm., a simple calculation gives the number of bacteria. The emulsion of bacteria is then diluted so that a certain number of millions shall be contained in each c.c., “standardized” as it is called, then heated to the proper temperature for the necessary time and it is ready for use. A preservative, as 0.5 per cent. phenol, tri- cresol, etc., is added unless the vaccine is to be used up at once. The amounts of culture, salt solution, etc., vary with the purpose for which the vaccine is to be used, from one or two agar slant cultures and a few c.c. of solution, when a single animal is to be treated, to bulk agar cultures and liters of solution as in preparing antityphoid vaccine on a large scale. Agar surface cultures are used so that there will be as little admixture of foreign protein as possible (see Anaphy- laxis, p. 264 et seq.). Normal saline solution is isotonic with the body cells and hence is employed as the vehicle. Vaccines are either ‘‘ autogenous” or “stock.” An ‘‘autog- enous” vaccine is a vaccine that is made from bacteria derived from the individual or animal which it is desired to vaccinate and contains not only the particular organism but the particular strain of that organism which is responsible for the lesion. Stock vaccines are made up from organisms like the infective agent in a given case but derived from some other person or animal or from laboratory cultures. Commercial vaccines are “stock” vaccines and are usually “polyvalent’”’ or even “mixed.” A “polyvalent” vaccine contains several strains of the infective agent and a “ mixed”’ contains several different organisms. Stock vaccines have shown their value when used as pre- ventive inoculations, notably so in typhoid fever in man, anthrax and black-leg in cattle. The author is strongly of the opinion, not only from the extended literature on the sub- ject, but also from his own experience in animal, and espe- cially in human cases, that stock vaccines are much inferior and much more uncertain in their action when used in the treatment of an infection, than are autogenous vaccines. This applies particularly to those instances in which streptococci, micrococe?, and colon bacilli are the causative agents, but to BACTERIAL VACCINES 261 others as well. The following are some of the reasons for this opinion: The above organisms are notoriously extremely variable in their virulence. While there is no necessarily close connection between virulence and antigenic property, yet since virulence is so variable, it is rational to assume that antigenic property is also extremely variable. Indi- viduals vary just as much in susceptibility and hence in reactive power, and generally speaking, an individual will react better in the production of antibodies to a stimulus to which he has been more or less subjected, 7. ¢., to organisms derived: from his own body. In the preparation of a vaccine great care must be used in heating so that the organisms are killed, but the antigens are not destroyed. Many of the enzymes present in bac- teria, especially the proteolytic ones, are not any more sen- sitive to heat than are the antigens, hence are not destroyed entirely. Therefore a vaccine kept in stock for long gradu- ally has some of its antigens destroyed by the uninjured enzymes present with them, and so loses in potency. There- fore in treating a given infection it is well to make up a vaccine from the lesion, use three or four doses and if more are necessary make up a new vaccine. If the above statements are borne in mind and vaccines are made and administered accordingly, the author is well satisfied that much better results will be secured. In accordance with the theory on which the use of vac- cines is based, 7. e., that they stimulate the body cells to produce immunizing antibodies, it is clear that they are espe- cially suitable in those infections in which the process is localized and should not be of much value in general infec- tions. In the latter case the cells of the body are stimulated to produce antibodies by the circulating organisms, prob- ably nearly to their limit, hence the introduction of more of the same organisms, capable of stimulating though dead, is apt to overtax the cells and do more harm than good. It is not possible to tell accurately when this limit is reached, but the clinical symptoms are a guide. If vaccines are used at all in general infections they should be given in the early stages and in small doses at first with close watch as to the effect. In localized infections only the cells in the immedi- 262 PHAGOCYTOSIS—OPSONINS ate neighborhood are much stimulated, hence the introduc- tion of a vaccine calls to their aid cells in the body gener- ally, and much more of the resulting antibodies are carried to the lesion in question. Manifestly surgical procedures such as incision, drainage, washing away of dead and ne- crotic tissue with normal saline, solution, not necessarily antiseptics, will aid the antibodies in their action and are to be recommended where indicated. In the practical application of any remedy the dosage is most important. . Unfortunately there is no accurate method of determining this with a vaccine. Wright recommended determining the number of the organisms per c.c. as before mentioned, and his method or some modification of it is still in general use. From what was said with regard to varia- tion, both in organisms and in individuals, it can be seen that the number of organisms is at least only a very rough guide. This is further illustrated by the doses of micrococcus (staphylococcus) vaccines recommended by different writers, which vary from 50,000,000 to 2,000,000,000 per c.c. The author is decidedly of the opinion that there is no way of determining the dosage of a vaccine in the treatment of any given case except by the result of the first dose. Hence it is his practice to make vaccines of a particular organism of the same approximate strength, and to give a dose of a measured portion of a cubic centimeter, judging the amount ‘by what the individual or animal can apparently withstand, without too violent a reaction. If there is no local or gen- eral reaction or if it is very slight and there is no effect on the lesion, the dose is too small. If there is a violent local reac- tion with severe constitutional symptoms clinically, and the lesion appears worse, the dose is too large. There should be some local reaction and some general, but not enough to cause more than a slight disturbance, easy to judge in human subjects, more difficult in animals. In cases suitable for vaccine treatment no serious results should follow from a properly prepared vaccine, though the process of healing may be delayed temporarily. Wright claimed, and many have substantiated him, that always following a vaccination there is a period when the resistance of the animal is dimin- ished. This is called the “negative phase,” and Wright AGGRESSIN 263 considered this to last as long as the opsonic index remained low, and when this latter began to increase the stage of the “positive” or favorable phase was reached. As has been stated the opsonic index is pretty generally regarded as of doubtful value, though the existence of a period of lowered resistance is theoretically probable from the fact that the body cells are called upon suddenly to do an extra amount of work and it takes them some time to adapt themselves. This time, the “negative phase,” is much better determined by the clinical symptoms, general and especially local. It is good practice to begin with a dose relatively small. The result of this is an indication of the proper dosage and also prepares the patient for a larger one. The second dose should follow the first not sooner than three or four days, and should be five to seven days if the first reaction is severe. These directions are not very definite, but clinical experience to date justifies them. It is worth the time and money to one who wishes to use vaccines to learn from one who has had experience both in making and administering them, and then to remember that each patient is an indi- vidual case for the use of vaccines as well as for any other kind of treatment. AGGRESSIN. Opsonins have been shown to be specific substances which act on bacteria in such a way as to render them more read- ily taken up by the leukocytes. By analogy one might expect to find bacteria secreting specific substances which would tend to counteract the destructive action of the phagocytes and bactericidal substances. Bail and_ his co-workers claim to have demonstrated such substances in exudates in certain diseases and have given the distinctive name “‘aggressins” to them. By injecting an animal with “agegressins,” antiaggressins are produced which counteract their effects and thus enable the bacteria to be destroyed. The existence of such specific bodies is not generally accepted as proved. The prevailing idea is that bacteria protect themselves in any given case by the various toxic substances © that they produce, and that “aggressins” as a special class of substances are not formed. CHAPTER XXXI. ANAPHYLAXIS. DaLiera, in 1874, and a number of physiologists of that period, observed peculiar skin eruptions following the trans- fusion of blood, that is, the introduction of foreign proteins. In the years subsequent to the introduction of diphtheria antitoxin (1890) characteristic ‘‘serum rashes’? were not infrequently reported, sometimes accompanied by more or less severe general symptoms and occasionally death —a train of phenomena to which the name “serum sickness” was later applied, since it was shown that it was the horse serum (foreign protein) that was the cause, and not the anti- toxin itself. In 1898 Richet and Hericourt noticed that some of the dogs which they were attempting to immunize against toxic eel serum not only were not immunized but suffered even more severely after the second injection. They obtained similar results with an extract of mussels which contain a toxin. Richet gave the name “anaphylaxis” (“no protection’’) to this phenomenon to distinguish it from immunity or prophylaxis (protection). All the above-mentioned observations led to no special investigations as to their cause. In 1903 Arthus noticed abscess formation, necrosis and sloughing following several injections of horse serum in immediately adjacent parts of the skin in rabbits (“Arthus’ phenomenon”). Theobald Smith, in 1904, observed the death of guinea-pigs following properly spaced injections of horse serum. This subject wasinvestigated by Otto and by Rosenau and Anderson in this country and about the same time von Pirquet and Schick were making a study of serum rashes mentioned above. The publications of these men led to a widespread study of the subject of injec- tions of foreign proteins. It is now a well-established fact that ANAPHYLAXIS 265 the injection into an animal of a foreign protein—vegetable, animal or bacterial, simple or complex—followed by a second injection after a proper length of time leads to a series of symptoms indicating poisoning, which may be so severe as to cause the death of the animal. Richet’s term “anaphylaxis” has been applied to the condition of the animal following the first injection and indicates that it is in a condition of supersensitiveness for the protein in ques- tion. The animal is said to be “sensitized’’ for that protein. The sensitization is specific since an animal injected with white of chicken’s egg’ reacts to a second injection of chicken’s egg only and not pigeon’s egg or blood serum or any other protein. The specific poisonous substance causing the symptoms has been called “anaphylotoxin” though what it is, is still a matter of investigation. It is evident that some sort of an antibody results from the first protein injected and that it is specific for its own antigen. A period of ten days is usually the minimum time that must elapse between the first and second injections in guinea- pigs in order that a reaction may result, though a large pri- mary dose requires much longer. If the second injection is made within less time no effect follows, and after three or more injections at intervals of about one week the animal fails to react at all, it has become “immune” to the protein. Furthermore, after an animal has been sensitized by one injection and has reacted to a second, then, if it does not die from the reaction, it fails to react to subsequent injec- tions. In this latter case it is said to be “antianaphylactic.” It must be remembered that proteins do not normally get into the circulation except by way of the alimentary tract. Here all proteins that are absorbed are first broken down to their constituent amino-acids, absorbed as such and these are built up into the proteins characteristic of the animal’s blood. Hence when protein as such gets into the blood it is a foreign substance to be disposed of. The blood contains proteolytic enzymes for certain proteins normally. It is also true that the body cells possess the property of digesting the proteins of the blood and building them up again into those which are characteristic of the cell. Hence it appears 266 ANAPHYLAXIS rational to assume that the foreign proteins act as stimuli to certain cells to produce more of the enzymes necessary to decompose them, so that they may be either built up into cell structure or eliminated as waste. If in this process of splitting up of protein a poison were produced, then the phenomena of ‘anaphylaxis’ could be better understood. As a matter of fact Vaughan and his co-workers have shown that by artificially splitting up proteins from many different sources—animal, vegetable, pathogenic and saprophytic bac- teria—a, poison 1s produced which appears to be the same in all cases and which causes the symptoms characteristic of anaphylaxis. On the basis of these facts it is seen that anaphylaxis is simply another variety of immunity. The specific antibody in this case is an enzyme which decomposes the protein instead of precipitating it. The enzyme must be specific for the protein since these differ in constitution. Vaughan even goes so far as to say that the poison is really the central ring common to all proteins and that they differ only in the lateral groups or side chains attached to this central nucleus. The action of the enzyme in this connec- tion would be to split off the side chains, and since these are the specific parts of the protein, the enzyme must be spe- cific for each protein. The pepsin of the gastric juice and the trypsin of the pancreas split the native proteins only to peptones. As is well known these when injected in suffi- cient quantity give rise to poisonous symptoms, and will also give rise to anaphylaxis under properly spaced injec- tions. They do not poison normally because they are split by the intestinal erepsin to amino-acids and absorbed as such. Whether Vaughan’s theory of protein structure is the true one or not remains to be demonstrated. It is not essen- tial to the theory of anaphylaxis above outlined, i. ¢., a phenomenon due to the action of specific antibodies which are enzymes. On physiological grounds this appears the most rational of the few explanations of anaphylaxis that have been offered and was taught by the author before he had read Vaughan’s theory along the same lines. On the basis of the author’s theory the phenomena of protein immunity and antianaphylaxis may be explained in ANAPHYLAXIS 267 the following way which the author has not seen presented. The enzymes necessary to decompose the injected protein are present in certain cells and are formed in larger amount by those cells to meet the increased demand due to injection of an excess of protein. They are retained in the cell for a time at least. If a second dose of protein is given before the enzymes are excreted from the cells as waste, this is digested within the cells in the normal manner. If a third dose is given, the cells adapt themselves to this increased intra- cellular digestion and it thus becomes normal to them. Hence the immunity is due to, this increased intracellular digestion. ; On the other hand, if the second injection is delayed long enough, then the eacess enzyme, but not all, is excreted from the cells and meets the second dose of protein in the blood stream and rapidly decomposes it there, so that more or less intoxication from ‘the split products results. This uses up excess enzyme, hence subsequent injections are not digested in the blood stream but within the cells as before. So that “antianaphylaxis” is dependent on the exhaustion of the excess enzyme in the blood, and the condition is funda- mentally the same as protein immunity. As has been indicated “serum sickness’ and sudden death following serum injections are probably due to a sensitization of the individual to the proteins of the horse in some unknown way. Possibly urticarial rashes and idiosyncrasies follow- ing the ingestion of certain foods—strawherries, eggs, oysters, etc., may be anaphylactic phenomena. In medical practice the reaction is used as a means of diagnosis in certain diseases, such as the tuberculin test in tuberculosis, the mallein test in glanders. The individual or animal with tuberculosis becomes sensitized to certain proteins of the tubercle bacillus and when these proteins in the form of tuberculin are introduced into the body a reac- tion results, local or general, according to the method of introduction. The practical facts in connection with the tuberculin test are also in harmony with the author’s theory of anaphylaxis as above outlined, Milder cases of tubercu- losis give more vigorous reactions because the intracellular 268 ANAPHYLAXIS enzymes are not used up rapidly enough since the products of the bacillus are secreted slowly in such cases. Hence excess of enzyme is free in the blood and the injection of the tuberculin meets it there and a vigorous reaction results. In old, far-advanced cases, no reaction occurs, because the enzymes are all used in decomposing the large amount of tuberculous protein constantly present in the blood. The fact that an animal which has once reacted fails to do so until several months afterward likewise depends on the fact that the excess enzyme is used in the reaction and time must elapse for a further excess to accumulate. The anaphylactic reaction has been made’ use of in the identification of various types of proteins and is of very great value since the reaction is so delicate, particularly when guinea-pigs are used as test animals. Wells has detected the 0.000,001 gm. of protein by this test. It is evi- dent that the test is applicable in medicolegal cases and in food examination and has been so used. SUMMARY. The discussion of “immunity problems” in the preceding chapters serves to show that protection from disease either as a condition natural to the animal or as an acquired state is dependent on certain properties of its body cells or fluids, or both. The actual factors so far as at present known may be summarized as follows: 1. Antitoxins which neutralize true toxins, shown to exist for very few diseases. 2. Cytolytte substances which destroy the invading organ- ism: in reality two substances; amboceptor, which is specific, and complement the real dissolving enzyme. 3. Phagocytosis or the destruction of the invading organ- isms within the leukocvtes. 4. Opsonins which render the bacteria more readily taken up by the phagocytes. 5. Enzymes other than complement possibly play a part in the destruction of some pathogenic organisms or their products. This 'remains to be more definitely established. ANAPHYLAXIS 269 6. It is possible that in natural immunity there might be no receptors in the body cells to take up the organisms or their products, or the receptors might be present in certain cells but of a very low chemical affinity, so that com- bination does not occur. It is even highly probable that many substances formed by invading organisms which might injure specialized cells, such as those of glandular, nervous or muscle tissue, have a more rapid rate of reaction with, or a stronger affinity for, lower unspecialized cells, such as con- nective and lymphoid tissue, and unite with these so that their effects are not noticed. The importance of these different factors varies in differ- ent diseases and need not be considered in this connection. The question “which of the body cells are engaged in the production of antibodies” is not uncommonly asked. On physiological grounds it would not seem reasonable that the highly specialized tissues above mentioned could take up this work, even though they are the ones which suffer the greatest injury in disease. Hence it is to be expected that the lower or unspecialized cells are the source, and it has been shown that the antibodies are produced by the phago- cytes (though not entirely as Metchnikoff maintained), by lymphoid tissue generally, by the bone marrow and also by connective-tissue cells, though in varying degrees. Since immunity depends on the activity of the body cells it is evident that one of the very best methods for avoiding infectious diseases is to keep these cells up to their highest state of efficiency, to keep in “good health.’’ Hence good health means not only freedom from disease but also protection against disease. List or Lasporatory EXERCISES GIVEN IN CONNECTION WITH THE CLAss Work INCLUDED IN THIS TEXT-BOOK. Exercise Exercise Exercise Exercise Exercise Exercise Exercise Exercise Exercise Exercise 10. Exercise 11. Exercise 12. Exercise 13. Exercise 14. Exercise 15. Exercise 16. Exercise 17. Exercise 18. Exercise 19. Exercise 20. Exercise 21. Exercise 22. Exercise. 23. Exercise 24. Exercise 25. Exercise 26. Exercise 27. Exercise 28, COMBA pw . Cleaning glassware. Preparation of broth medium from meat juice. . Preparation of gelatin medium from broth. . Preparation of agar medium from broth. Potato tubes. . Potato plates. . Plain milk tubes. . Litmus milk tubes. . Sugar broth media. Blood-serum tubes. Inoculation of tubes. proteins. Production of gas from carbohydrates. Production of indol. Reduction of nitrates. Chromogenesis: Illustrates nicely the varia- tion with environment. Enzyme production. Making of plate cultures; isolation in pure culture. Stain making and staining. Cell forms and cell groupings. Hanging drop slides. Staining of spores. Staining of acid-fast bacteria. Staining of capsules. Staining of flagella. Study of individual species. Determination of thermal death-point. Action of disinfectants on bacteria. Action of sunlight on bacteria. Action on complex INDEX. A Apps, 28 condenser, 184-185 ABILGAARD, 24 Abortion, contagious, 224, 226, 253 Abrin, 239 Absorption of free nitrogen, 105 Accidental carriers, 220 structures, 40 Acetic acid, 88 fermentation, 29 Achorion schoenleinii, 25 Acid, acetic, 88 fermentation, 29 butyric, 88 fermentation, 29 carbolic, first used, 26 fast bacilli, staining of, 193 bacteria, 73 fermentation, 82 hydrochloric, 225 lactic, fermentation, 85-88 production of, 98 soils, 70 Acquired immunity, 230 Actinomyces bovis, 27 Actinomycosis, 223 Actions, reducing, 101 Activating enzymes, 113 Active immunity, 230 production of, 230-232 Activities, physiological, definition of, 76 in identification, 199 Activity, overproduction, of cells, 235, 236 Acute coryza, 223 disease, 214 Aérobe, facultative, 66 Aérobes, 66 Aérobic, 66 Agar medium, 163-164 Agent, choice of, for disinfection, 151-156 Agents, physical, for disinfection, 119-143 Agglutinating group, 243 Agglutination, 242 macroscopic, 242 microscopic, 242 Agglutinin, 242 bacterial, 242 hema-, 242 Agglutinins, 242-245 anti-, 246 co-, 244 compared with precipitins, 245 functions of, 243 normal, 243 specificity of, 244 theory of formation of, 242 use of, 243, 244 Agglutinogen, 243 Aggressin, 263 ugg 2 isolation of bacteria, 182, Air, bacteria in, 61 filtration, 141 Albumin in bacteria, 73 Alcohol as disinfectant, 148 Alcoholase, 113 Alcoholic fermentation, 29, 89 Alexin, 248 Alge, relation to bacteria, 34 Alimentary tract as channel of infection, 225 Amboceptor, 250 hemolytic, 254 partial, 251 specific, 254 Amboceptorogen, 251 272 Amboceptors, 250 anti-, 251, 252 co-, 251 specificity of, 250 Ameba coli, 27 Ameboid colony, 207 Ammoniacal fermentation, 29 Amphitrichic, 43 Amylase, 112 Anaérobe, facultative, 66 Anaérobes, 66 Anaérobic, 66 bacteria, first discovered, 29 organisms, cultivation of, 172- 176 Analysis, chemical, of tubercle bacilli, 74 of ash, 71 Anaphylactic, anti-, 265, 267 phenomena, 267 reaction, uses of, 268 Anaphylatoxin, 265 Anaphylaxis, 264-268 anti-, 267 antibodies in, 266 theory of, 266 ANDERSON, 264 Awnory, Nicuouas, 24 Anilin dyes, 27, 188 fuchsin, 189 gentian violet, 189 Animal inoculation, 210 Animalcules, bacteria considered to be, 19 Animals, disinfection of, 155 experimental, 210 Ankylostomum duodenale, 26 Anthrax, 26, 218, 222, 225, 226 spores of, 27 vaccine, 231 Antiagglutinins, 246 Antiaggressin, 263 Antiamboceptors, 251, 252 Antianaphylactic, 265 Antianaphylaxis, 267 Antibacterial immunity, 232 Antibodies, 237 in anaphylaxis, 266 place of production of, 269 Antibody formation, 116 Anticomplement, 251 Antidiphtheritic serum, 240 Antienzyme, 239 Antienzymes, 238-241 INDEX Antigen, 237 syphilitic, 254 Antipollenin, 240 Antiprecipitins, 246 Antisepsis, 119 Antiseptic, 119 methods introduced, 26 Antisnake venoms, 252 Antitetanic serum, 240 Antitoxic immunity, 232 Antitoxin, 238 diphtheria, 28 preparation of, 240 standard, 241 unit of, 241 Antitoxins, 238-241, 268 Antivenin, 240 Apex of lung, 227 Apparatus of Barber, 180 Appearance of growth in identifi- cation, 200 AppERT, 20 Aqueous gentian violet, 189 Arborescent growth, 204 Aromatic compounds, 93 production of, 99 ARTHUS, 264 Arthus’s phenomenon, 264 Articles, unwashable, disinfection of, 155 washable, disinfection of, 155 Artificial immunity, 230 Ase, termination of name of enzyme, 112 Asepsis, 119 Aseptic, 119 Ash, analysis of, 71 Asiatic cholera, 227 Attenuated, 231 Autoclave, 125 Autogenous vaccine, 260 Autoinfection, 216 Autolysis, 114 Autotrophic, 75 Azotobacter, 106 B Bases-Ernst corpuscles, 42 Bacilli, butter, 193 colon, 226 grass, 193 tubercle, chemical analysis of, 74 INDEX Bacillus, 49, 59 botulinus, 98, 116, 218, 238 coli, 67, 84, 148, 161, 316, 224 Ducrey! 8, 224 enteritidis, 93 fluorescens, 67 of blue milk, 29 pastorianus, 106 prodigiosus, 67 subtilis, 67, 72, 193 tetani, 116, 193, 215, 238, 240 typhosus, 63, 224, 242 vulgaris, 67 Bacteria, acid-fast, 73 aids in isolation of, 182, 183 anaérobic, first: discovered, 29 as scavengers, 95 chemical elements in, 71 classed as fungi, 34 considered to be animalcules, 19 definition of, 37 energy relationships of, 36, 37 first classed as plants, 30 seen, 18 shown to cause disease, 27 in feces, 62 in the air, 61 in the sea, 61 in the soil, 61 in-urine, 62 in water, 61 iron, 75, 78 isolation of, 178-183 measurement of, 37 metabolism of, 75-81 morphology of, 39 motile, 42 nitric, 103 nitrous, 102 occurrence, 61 pathogenic, outside the body, 218 position of, 34 rate of movement of, 42 related to protozoa, 37 relation to alge, 34 to molds, 34 to yeasts, 34 relationships of, 34 size of, 37 staining of, 188-195 study of, 157 of physiology of, 196-209 sulphur, 75, 94 18 273 Bacteriacece, 59 Bacterial agglutinin, 242 vaccines, 258 preparation of, 259, 261 Bacterin, 231 Bacteriocidin, 249 Bacteriological examination, ma- terial for, 211 microscope, 184 Bacteriology, pathogenic, defini- tion of, 213 reasons for study, 217 \Bacteriolysin, 249 ‘Bacteriotropin, 257 Bacterium, 59 abortus, 242 acidt oxalici, 72 anthracis, 148, 193 diphtheria, 116, 215, 216, 238, 240 lepre, 193 malle?, 242 of Johne’s disease, 193 smegmatis, 193 study of, necessary steps for, 158 tuberculosis, 72, 160, 193 aylinum, 72 BarsBer and Wess, 231 apparatus, 180 Barnyards, disinfection of, 153-155 Baskets, wire, 168 Bass, 25 ; Bastian, Dr. CHaruton, 23 BAUMGARTNER, 234 Beaded growth, 204 Bed-bugs as carriers, 220 Beds, contact, 104 Beer, pasteurization of, 129, 133 Beggiatoa, 60 Beggiatoacee, 60 BrEuRING, 28 BELFANTI, 248 Bere, 25 BERKEFELD, 142 Bichloride of mercury as disinfec- tant, 146 BILHaRzZ, 26 Bilharzia disease, 26 Biochemie! reactions, definition of, 6 Bipolar germination of spore, 46 Black-leg, 218, 222, 226 vaccine, 231 Bleaching powder as disinfectant, 146 274 Blood, detection of, 246 serum, Loeffler’s, 166 medium, 166, 167 Blue milk bacillus, 29 fermentation, 29 Borum, 25 Boils, 216, 222 Bo.uincER, 27 Bonnet, 19 Borpet, 248 Botrytis bassiana, 25 Bottles, staining, 190 Bougie, 141 Bouillon, 159 Bread, salt rising, 84 Bronchopneumonia, 215, 224 Broth, glycerin, 160 meat, 159 nitrate, 161 sugar, 160 Brownian motion, 44 movement, 44 Bucuner, 248 Budding of yeasts, 34 Burning, 120 Burying, 142 Butter bacilli, 193 rancidity of, 90 Butyric acid, 88 fermentation, 29 Buzzards as carriers, 220 Cc Ca1Gnarp-LatTour, 29 Calcium hypochlorite as disinfec- tant, 146 oxide as disinfectant, 146 Candles, filter, 141 Canned goods, spoiling of, 48 Canning, 68 Capsule, 41 of the spore, 45 Capsules, staining of, 194 Carbohydrates, fermentation of, 82 in bacteria, 73 Carbol-fuchsin, 189 Carbolic acid as disinfectant, 147 first used, 26 Carbon, circulation of, 96 uses of, 77 CarBone, 248 Carriers, 219 INDEX Carriers, accidental, 220 Cars, stock, disinfection of, 155 Catalase, 113 Catalyzer, 111 ; Causation of disease, 23, 116 Cell contents, 39 forms, 49, 55 staining for, 195 groupings, 52-55 staining for, 195 structures, 39 wall, 39 composition of, 72 | Cells, chemical stimuli of, 235 overproduction activity of, 235, 236 specific 235 ; Cellular theory of immunity, 234 Cellulose, 72 : Chain, 52 Channels of infection, 222 alimentary tract, 225 conjunctiva, 223 external auditory meatus, 223 genitalia, 224 intestines, 225 lungs, 224 milk glands, 223 mouth cavity, 223 mucose, 223 nasal cavity, 223 pharynx, 223 skin, 222 stomach, 225 tonsils, 223 Chaos, 24 Characteristics of toxins, 114, 115 Cuarrin, 242 Chart, descriptive, 200 CHAUVEAU, 234 Cheese, eyes in, 85 poisoning, 93 ripening, 29 Chemical analysis of tubercle bacilli, 74 composition, 70-74 of bacteria, 36 elements in bacteria, 71 stimuli, effect of, 236 of cells, 235 specific, 236 theory of immunity, 234 Chemotherapy, 227, 232 chemical stimuli of, INDEX CHEVREUIL and Pasteur, 21, 25, 29 Chicken-pox, 224 Chitin, 72 Chlamydobacteriacee, 60 Chlamydothrix, 60 Chloride of lime as disinfectant, 146 Chlorine as disinfectant, 145 Chloroform as disinfectant, 150 Chlorophyl, absent in bacteria, 34 Chlorosis, Egyptian, 26 Cholera, Asiatic, 227 hog, 220, 226, 230 Choleras, 225, 226, 227 Chromogenesis, 100 Chromoparic, 100 Chromophoric, 100 Chronic disease, 214 Chronological index, 31 Circulation of carbon, 96 of nitrogen, 96 of phosphorus, 96 of sulphur, 97 Cladothriz, 60 Classification, first attempt at, 30 Migula’s, 59, 60 Cleaning of slide, 191 Clostridium, 47, 106 Clothing for disinfection, 156 Coagglutinins, 244 Coagulases, 112 Coagulating enzymes, 112 Coamboceptors, 251 Cobra, 252 Coccacee, 59 Coccus, 49 Coenzymes, 110 Coun, 26, 30 Cold, 136 incubator, 198 ‘Colds, 223 Colon bacilli, 226 » Colonies, plate, study of, 209 Colony, 159 ameboid, 207 effuse, 207 punctiform, 206 thizoid, 206, 208 » Combustion, spontaneous, 104 Commensal, 76 Complement, 250 anti-, 251 deviation test, 253 fixation test, 253-255 275 Complement, lecithin as, 251 source of, 254 Complementoid, 250 Complementophil haptophore, 250 Complements, 251 : Composition, chemical, 70-74 of bacteria, 36 Compounds, aromatic, 93 Compressed oxygen, 67 Condenser, Abbé, 184, 185 Conditions for formation of spores, 48 for growth, general, 62 maximum, 62 minimum, 62 optimum, 62 Conjunctiva as channel of infec- tion, 223 Contact beds, 104 Contagion, direct and indirect, 23 Contagious abortion, 224, 226, 253 diseases, 25, 214 Contagium vivum, 23 Contents, cell, 39 Continuous pasteurization, 129 Corpuscles, Babes-Ernst, 42 red, 227 Corrosive sublimate as disinfectant, 146 Coryza, acute, 223 Cotton plugs, 20, 168 Coughing, 226 Crateriform liquefaction, 205 Cream, ripening of, 86 CrEItTE, 248 Crenothrix, 60 Creolin as disinfectant, 148 Creosols as disinfectants, 147 Cultivation of anaérobic organisms, 170-176 Cultural characteristics as physio- logical activity, 117 Culture medium, 157 essentials of, 158 gelatin, 161-163 inoculation of, 170, 176 pure, 157 tubes, 168 Cultures, mass, 172 plate, 164, 172 puncture, 169 pure, methods of obtaining, 178- 183 slant, 170 276 Cultures, slope, 170 stab, 169 Curled edge, 208 Cutaneous inoculation, 211 Cycle, nitrogen, etc., 96, 97 Cytolysin, 249 Cytolysins, 248-255 Cytolytic, 249 ; serums, failure of, 252 substances, 268 Cytophil haptophore, 250 Cytoplasm, 39 Cytotoxic, 249 D Da.iera, 264 DavaineE and Rayer, 26 Death-point, thermal, 65 determination of, 198 Decomposition of urea, 95 Deep culture tubes, 174 Definition of bacteria, 37 of immunity, 217 of pathogenic bacteriology, 213 of spore, 48 of unit, 241 Degeneration forms, 51 Denitrification, 102 Deodorant, 119 Deposits of sulphur, 104 Descriptive chart, 200 Detection of blood, 246 a of oxygen relations, of thermal death-point, 198 Deviation test, complement, 253 Diastase, 112 Diffusion, food of bacteria by, 36 Digestion of milk, 91 . Diluting blood serum, necessity for, 244 Dilution plates, 178 Diphtheria, 223, 227 antitoxin, 28 Diplobacillus, 52 Diplococcus, 53 Diplospirillum, 52 Discharges, intestinal, 226 nasal, 226 urethral, 226 vaginal, 226 Discontinuous sterilizaticn, 121 INDEX Disease, acute, 214 Bilharzia, 26 causation of, 23, 116 chronic, 214 contagious, 25 foot-and-mouth, 223, 226 germs, 23 hookworm, 26 Johne’s, 225, 226 non-specific, 215 of flies, 26 of silkworms, 26 silkworm, 25 Diseases, contagious, 214 infectious, 213 skin, 222 specific, 215 Dishes, Petri, 164 Disinfectant, 119 Disinfectants, factors affecting, 152-156 Disinfection, 118 and sterilization, practical, 152- 156 chemical agents, 144-150 choice of agent, 151-156 clothing for, 156 of animals, 155 of barnyards, 153-155 of harness, 155 of manure, liquid, 155 of rooms, 153 of stables, 153-155 of stock cars, 155 of surgical instruments, 153 of unwashable articles, 155 of vehicles, 155 : of washable articles, 155 physical agents for, 119-143 steam and formaldehyde, 156 Dissemination of organisms in the body, 225 Distilling, sour mash, 87 Division, planes of, 53 rate of, 80 Dosage of vaccines, 262 Dose, minimum lethal, 241 standard test, 241 Dovatas, 256 Dourine, 224, 226 Drumstick spore, 47 Dry heat, 121 Drying, 119 Ducrey’s bacillus, 224 INDEX Dunham’s peptone solution, 161 Douruam, 242 Dyes, anilin, 28, 188 Dysenteries, 225, 226, 227 Dysentery, tropical, 27 ; E Ecroriasm, 39 Edge, coarsely granular, 208 curled, 208 entire, 208 lacerate, 207 rhizoid, 208 Edema, malignant, 218, 222 Effuse colony, 205 EHRENBERG, 30 Euruicu, 234 Ehrlich’s theory of formation of precipitins, 245 of immunity, fundamental principles of, 235 summary of, 237 EIcusTep, 26 Electric milk purifier, 139, 140 Electricity, 68, 138 Elements, chemical, in bacteria, 71 Elimination of pathogenic organ- isms, 226 paths of, gall-bladder, 226 kidneys, 226 saliva, 226 urine, 226 Empusa muce, 26 Endo-enzymes, 114 Endogenous infection, 216 Endoplasm, 39 Endotoxins, 116 Energy relationships of bacteria, Ensilage, 87 Enteritis, 215 Entire edge, 208 Entrance, paths of, of pathogenic organisms, 222 Enzyme, final test for, 111 Enzymes, 109-114, 268 activating, 113 and toxins compared, 114, 115 as catalyzers, 111 chief characteristics of, 111 classification of, 112, 113 co-, 110 277 Enzymes, coagulating, 112 name of, 112 oxidizing, 113 produced by all cells, 112 production of, 109 reducing, 113 similar to living organisms, 109, 110 splitting, 112 , Enzymoid, 239 Epitheliolysin, 249 Equatorial germination of spore, 45 Erysipelas, hog, 226 Essential structures, 39 Essentials of a culture medium, 158 Esters, production of, 98 Ether as disinfectant, 150 Eubacteria, 59 Examination, bacteriological, mate- rial for, 211 Exanthemata, 226 Exhaustion theory of immunity, 234 Exo-enzymes, 114 ‘ Exogenous infection, 216 Exotoxins, 116 Experimental animals, 210 Explanation of natural immunity, 216 External auditory meatus as chan- nel of infection, 223 genitalia, 227 as channels of infection, 224 Eyes in cheese, 85 F Factors affecting disinfectants, 151, 152 modifying immunity, 228 Facultative, 66 aérobe, 66 anaérobe, 66 parasite, 76 Failure of cytolytic serums, 252 of vaccines, 261 Fats in bacteria, 73 splitting of, 90 Favus, 25 Feces, bacteria in, 62 Fermentation, 82 acetic acid, 29, 88 acid, 82 278 Fermentation alcohols, 29, 89 ammoniacal, and aca a 28 blue milk, 29 butyric acid, 29, 88 gaseous, 82 lactic acid, 85-88 of carbohydrates, 82 tubes, 68, 174 Ferments, organized, 114 unorganized, 114 Fever, Malta, 245 recurrent, 27 scarlet, 224, 226 Texas, 214, 215, 220 typhoid, 214, 226 yellow, 221 Filament, 52 Filiform growth, 204 Film, fixing of, 191 preparation of, 190 Filter, Berkefeld, 142 candles, 141 Pasteur-Chamberland, 142 sprinkling, 104 Filterable organisms, 216 virus, 216 Filtration, 140, 141 air, 141 water, 141 First order, receptors of 239 Fixation test, complement, 253-255 Fixed, 254 Fixing of film, 191 Flagella, position of, 42, 43 staining of, 194 Flagellum, 42 Flash process, 133 Fleas as carriers, 220 FLEXNER, 253 Flies as carriers, 220 disease of, 26 . Fitiacr, 248 Fopor, von, 248 Food taken in by diffusion, 36 uses of, 75 Foot-and-mouth disease, 223, 226 Foreign-body pneumonia, 224 Formaldehyde and steam disinfec- tion, 156 as disinfectant, 148-150 Formation of agglutinins, theory of, 24 of antibodies, 116 INDEX Formation of precipitins, Ehrlich’s theory, 245 of spores, 45 conditions for, 48 Forms, cell, 49, 55 degeneration, 51 growth, 51 involution, 51 study of, 30 Foxes as carriers, 220 FRACASTORIUS, 23 Free receptors, 237 spore, 45 Fucus, C. J., 29 Fuchsin, anilin, 189 carbol, 189 Functions of agglutinin, 243 Fungi, bacteria classed as, 34 Funnel-shaped liquefaction, 205 G GasBsEtT’s blue, 190 method of staining, 193 Gall-bladder as a path of elimina- tion, 226 Gas, natural, 84 production of, 98 Gaseous fermentation, 82 GasparD, 25 Gelatin culture medium, 161-163 liquefaction of, 92 plates first used, 27 General conditions for growth, 62 infections, vaccines in, 261 Generation, spontaneous, 17 Generic names introduced, 30 Genitalia, external, 227 as channels of. infection, 224 Gentian violet, anilin, 18 aqueous, 189 German measles, 214 Germination of spore, 45 bipolar, 46 eae 45 oblique, 45 polar, 45 Germs, disease, 23 GuscHEIDEL, 248 ‘Glanders, 215, 223, 224, 226, 227, 253 infectious, 24 mallease, reaction in, 246 INDEX Glands, mammary, 226 salivary, 226 GLEIcHEN, 30 Globulin in bacteria, 73 Glycerin broth, 159 Glycerinized potato, 166 Gonococcus, 224 Gonorrhea, 226, 227 Good health, 269 Grain rust, 25 Gram-negative, 192 positive, 192 Gram’s method of staining, 191 , solution, 192 Granular, coarsely, edge; 208 Granules, metachromatic, 42 Neisser, 42 .. polar, 42 Grape juice, pasteurization of, 129, 132 ‘ Grass bacilli, 193 ren plants, nitrogen nutrition of, 10 GRIESINGER, 26 Group, agglutinating, 243 haptophore, 238, 239, 243, 247, 250, precipitating, 246 ' toxophore, 250 zymophore, 239, 247, 250 Groupings, cell, 52, 55 Growth, appearance of, in identifi- cation, 200 arborescent, 204 beaded, 204 filiform, 204 forms, 51 papillate, 204 villous, 204 GRuBER, 242 Gruber-Widal test, 244 Grusy, 25 H HAECKEL, 256 Hanging drop slide, 185 Hansen, Emit Cur., 27 Haptophore, complementophil, 250 cytophil, 250 group, 238, 239, 243, 247, 250 Harness, etc., disinfection of, 155 Health, good, 269 279 Heat, 119-135 dry, 121 moist, 121 production of, 104 Heated serum, 248 Hemagglutinin, 242 Hemicellulose, 72 Hemolysin, 249 Hemolytic amboceptor, 254 | Hemorrhagic septicemias, 225 HENLE, 25, 215 Hericourt, 264 Herpes tonsurans, 25 HESSELING, VON, 29 Heterologous, 252 Heterotrophic, 75 Hitt, 30 HorrMan, 23 Hog cholera, 220, 226, 230 erysipelas, 226 Homologous, 253 Hookworm disease, 26 Host, 76 Hot beds, 105 Hydrochloric acid, 225 ; Hydrogen peroxide as disinfectant, 145, 150 uses of, 78 Hydrophobia, 227 Hydrostatic pressure, 69 Hypochlorites as disinfectant, 145 I Icr-cREAM poisoning, 93 Identification,appearance of growth in, 200 of blood, 246 of meat, 246 of milk, 246 physiological activities in, 199 ° Immunity, 228 acquired, 230 active, 230 production of, 230-232 antibacterial, 232 antitoxic, 232 artificial, 230 cellular theory of, 234 chemical theory of, 234 definition of, 213 Ehrlich’s theory of, fundamental | principles of, 235 , 280 Immunity, Ehrlich’s theory of, summary of, 237 exhaustion theory of, 234 inherited, 230 natural, 230 explanation of, 269 noxious retention theory of, 234 outlines of, 229 passive, 230. phagocytosis theory of, 234 relative, 228 serum-simultaneous method in, 231 side-chain theory of, 234 summary of, 268 theories of, 234 to protein, 265, 267 unfavorable environment theory of, 234 Inactivated, 249 Incubation, period of, 214 Incubator, cold, 198 Incubators, 196 Index, chronological, 31 opsonic, 257, 258 phagocytic, 257 Indicator, 254 Indol, 93 Infection, 214 auto-, 216 channels of, 222 endogenous, 216 exogenous, 216 mixed, 216 primary, 216 secondary, 216 wound, 25, 27, 215 caused by bacteria, 27 Infections, general, vaccines in, 261 localized, vaccines in, 261 Infectious diseases, 213 Infective organisms, specificity of location of, 227 Infestation, 214 Infested, 214 Influenza, 224, 226, 227 Infusoria, 30 Inherited immunity, 230 Inoculation, 210 by feeding, 211 by inhalation, 211 cutaneous, 211 intracardiac, 211 intramuscular, 211 INDEX Inoculation, intra-ocular, 211 intraperitoneal, 211 intraspinal, 211 intrathoracic, 211 intravenous, 211 needles, 176 of culture medium, 170, 176 subcutaneous, 210 subdural, 211 Inoculations, protective, first, 26 Instruments, surgical, disinfection of, 153 Intestinal discharges, 226 Intestine, large, 227 small, 227 Intestines as channel of infection, 22 Intracardiac inoculation, 211 Intramuscular inoculation, 211 Intra-ocular inoculation, 211 Intraperitoneal inoculation, 211 Intraspinal inoculation, 211 Intrathoracic inoculation, 211 Intravenous inoculation, 211 Invasion, 214 Invertase, 112 Involution forms, 51 Todine as disinfectant, 145 Iron bacteria, 75, 78 uses of, 78 Isolation of bacteria, 178-183 aids in, 182, 183 J JAaBLoT, 30 Jack o’lanterns, 94 Jar, Novy, 175 Johne’s disease, 225, 226 K Kerrte, 29 Kidneys as path of elimination, 226 Kinase, 113 Kircuer, 18, 23 IXLEess, 27 KLENCKE, 26 Kocn, Rosert, 17, 27, 31, 215, 248 Ixoch’s postulates, 215 Kravs, 245 Kruse, 231 KKUicHENMEISTER, 26 INDEX L Lacrrate edge, 207 Lactacidase, 113 Lactic acid fermentation, 85-88 Lancisi, 24 Lanpo!ls, 248 Large intestine, 227 Latour, 29 LavERAN, 24, 28 Lecithin as complement, 251 LErvwENHOEK, ANTHONY VAN, 18 Legumes, 106 : Leivy, Joszrsu, 30 Leprosy, 215, 223, 227 Lesser, 30 Lethal dose, minimum, 241 Leukocytes, washing of, 257 Lice as carriers, 220 Li=BERT, 26 Light, 65, 136 production of, 99 LinnaEvs, 24 Lipase, 112 Liquefaction, crateriform, 205 funnel-shaped, 205 of gelatin, 92 saccate, 205 stratiform, 205 Liquid manure, disinfection of, 155 media, 158 Lister, 26 Litmus milk, 161 Lobar pneumonia, 224 a infections, vaccines in, 61 Location, specificity of, of infective organisms, 227 Loeffler’s blood serum, 166 blue, 189 Léscu, 27 Loop needles, 177 Lopotrichic, 43 Lung, apex of, 227 Lungs, 227 as channels of infection, 224 Lysol as disinfectant, 148 M McCoy, Vira, 148 Macrococcus, 49 Macroscopic agglutination, 242 281 Malaria, 24, 214, 220, 227 Malarial parasite, 28 Mallease reaction in glanders, 246 Mallein test, 267 Malignant edema, 218, 222 Malta fever, 245 Mammary gland, 226 Manure, liquid disinfection of, 155 Margaropus annulatus, 220 MartTINn, 29 Mass cultures, 172 - Material for bacteriological exami- nation, 211 Maximum conditions, 62 Measles, 224, 226 German, 214 Measly pork, 26 , Measurement of bacteria, 37 Meat broth, 159 identification of, 246 poisoning, 93 Meatus, external auditory, as chan- nel of infection, 223 Mechanical vibration, 69 Media, liquid, 158 selective, 182, 183 solid, 158 synthetic, 158 Medium, agar, 163, 164 blood serum, 166, 167 culture, 157 essentials of, 158 inoculation of, 170, 176 gelatin, 161-163 large quantities of, 172 potato, 164-166 reaction of, 70 synthetic, 167 Meningitis, 223 Meningococcus, 223 Meanie chloride as disinfectant, 146 Merismopedia, 54 Metabiosis, 92 Metabolism of bacteria, 75- ‘81 relative to man, 81 Metachromatic granules, 42 Metastases, 216 Metatrophic, 75 Metcunikorr, 234, 256 Methods, antiseptic, 26 of ebieining pure cultures, 178- Microbiology, 213 282 INDEX Micrococci, 226 N Micrococcus, 49, 59, 223, 224 pyogenes aureus, 148 N&cEtt, 30 Micromillimeter, 37 Micron, 37 Microscope, bacteriological, 184 improvements in, 28 invented, 18 Microscopic agglutination, 242 Microspira, 60 comma, 63 Microsporon furfur, 26 Migula’s classification, 59, 60 Milk, 161 ; blue, bacillus of, 27 fermentation in, 29 digestion of, 91 ee as channel of infection, identification of, 246 litmus, 161 pasteurization of, 129, 132, 133, 134, 135 purifier, electric, 139, 140 souring of, 29 tuberculous, 226 Minimum conditions, 62 lethal dose, 241 Mixed infection, 216 vaccine, 260 Mixotrophic, 75 M. L. D., 241 Moist heat, 121 Moisture, 63 Molds, relation to bacteria, 34 Monas, introduced, 30 Monotrichic, 42 Mordants, 188 Morphology of bacteria, 39-55 Mosquito theory of malaria, 24 Motile bacteria, 42 Motion, Brownian, 44 Mouth cavity as channel of infec- tion, :223 Movement, Brownian, 44 rate of, in bacteria, 42 By, 37 Mu, 37 Mucose as channels of infection, 223 Miter, 30 Minrz, 30 Mycoproteid, 72 Myxomycetes, 36 Names, generic, introduced, 30 Nasal cavity as channel of infec- tion, 223 discharges, 226 Natural gas, 84 immunity, 230 explanation of, 269 NrEpuaM, 19 Needles, inoculation, 176 loop, 17 platinum, 176 straight, 176 Negative phase, 262, 263 test, 255 Neisser granules, 42 Nephrolysin, 249 NEUFELD, 257 Neurotoxin, 249 Nichrome wire, 177 Nitrate broth, 161 Nitric bacteria, 103 Nitrification, 103 due to organisms, 30 Nitrifying organisms, 30 Nitrogen, absorption of, 105 circulation of, 96 nutrition of green plants, 107 uses of, 78 Nitrous bacteria, 102 Non-pathogenic, 76 Non-specific disease, 215 Normal agglutinins, 243 Nosema bombycis, 27 Novy jar, 175 ‘| Noxious retention theory of im- munity, 234 Nuclein, 40 in bacteria, 73 Nucleus, 40 Nutrition of green plants, nitrog- enous, 107 Nurta, 248 ce) OBERMEIER, 27 Objective, oil immersion, 184, 185 Oblique germination of spore, 45 Occurrence of bacteria, 51 | Oidium albicans, 25 INDEX Oil immersion objective, 184, 185 Opsonic index, 257, 258 value of, 258 power, 257 Opsonin, 256 Opsonins, 256-263, 268 ‘ -antibodies of second order, 257 ispecificity of, 257 Optimum conditions, 62 Order, first, receptors of, 239 second, receptors of, 242, 247 third, receptors of, 248, 250 Organisms, anaérobic, cultivation of, 172-176 dissemination of, in the body, 225 filterable, 216 aa specificity of location, 2 nitrifying, 30 pathogenic, elimination of, 226 paths of entrance, 222 ultramicroscopic, 215 Organized ferments, 114 Osmotic pressure, 68, 137 Otitis media, 223 Orro, 264 Outlines of immunity, 229 Overproduction activity of cells, 235, 236 Oxidation, 102 Oxidizing enzymes, 113 Oxygen, 66 as disinfectant, 144 compressed, 67 pressure, 66, 67 relations, determination of, 198 uses of, 77 Oznam, 24 Ozone, 67, 138 as disinfectant, 145 Pp. PaNncrEAs, 226 Papillate growth, 204 Parasite, 76 facultative, 76 of malaria, 28 strict, 76 Partial amboceptor, 251 Passive immunity, 230 Pasteur, 21, 25, 26, 27, 28, 29, 231, 234 283 Pasteur flask, 22, 23 | treatment of rabies, 231 Pasteur-Chamberland filter, 142 Pasteurization, 127-135 continuous, 129 of beer, 129, 133 of grape juice, 129, 132 of milk, 129-132, 133, 134, 135 of wine, 129 Pathogenic, 76 bacteria, definition of, 213 outside body, 218 a reasons for study, 21 organisms, elimination of, 226 paths of entrance, 222 Paths of elimination, gall-bladder, 226 kidneys, 226 saliva, 226 urine, 226 of entrance of pathogenic organ- isms, 222 Pebrine, 26 Peptone solution, Dunham’s, 161 Period of incubation, 214 Peritrichic, 43 Peronospora infestans, 26 Prrty, 30 Petri dishes, 164 Petroleum, 84 PFEIFFER, 248 phenomenon, 248 Phagocytes, 234 Phagocytic index, 257 Phagocytosis, 256-263, 268 theory of immunity, 234 ee as channel of infection, Phase, negative, 262, 263 positive, 263 Phenol as disinfectant, 147 Phenomena, anaphylactic, 267 Phenomenon, Arthus’s, 264 Pfeiffer’s, 248 Phosphate rock, 103 Phosphine, 94 Phosphorescence, 99 Phosphorus, circulation of, 96 uses of, 79 Photogenesis, 99 Physical agents for disinfection, 119-143 284 Physiological activities, definition of, 76 use in identification, 199 Physiology of bacteria, study of, 196-209 Pigment, production of, 100 Pimples, 216, 222 Piroplasma bigeminum, 215, 220 Piroplasmoses, 220, 222 Piroplasms, 227 von PirQvET, 264 Pityriasis versicolor, 26 Plague, 224 Planes of division, 53 determination of, 54 Planococcus, 59 Planosarcina, 59 Plasmodiophora brassice, 27 Plasmolysis, 39 Plasmoptysis, 40 Plate colonies, study of, 209 cultures, 164, 172 Plates, dilution, 178 gelatin, first used, 27 Platinum needles, 176 Plectridium, 47 PLENciIz, 24, 28 Plugs, cotton, 168 Pneumococcus, 224 Pneumonia, broncho-, 224 foreign body, 224 lobar, 224 Pneumonias, 226 Poisoning, cheese, 93 ice-cream, 93 meat, 93 Polar germination of spore, 45 granules, 42 Poliomyelitis, 223 POLLENDER, 26 Polyvalent vaccine, 260 Pork, measly, 26 Position of bacteria, 34 of flagella, 42, 43 of spore, 46, 47 Positive phase, 263 test, 255 Postulates, Koch’s, 215 Potato, glycerinized, 166 medium, 164-166 rot, 26 Power, opsonic, 257 Practical sterilization and disinfec- tion, 152-156 INDEX Pragmidiothriz, 60 Precipitatory group, 246 Precipitin, 245 Precipitinogen, 245 -Precipitins, 245-247 anti-, 246 compared with agglutinins, 245 formation of, Ehrlich’s theory, 245 uses of, 246 Preparation of antitoxin, 240 of bacterial vaccine, 259, 261 of film, 190 Preservative in vaccine, 260 Pressure, hydrostatic, 69 osmotic, 68, 137 oxygen, 66, 67 steam, 124 Preventatives, stock vaccines as, 260 Prevost, 25 Primary infection, 216 Production of acid, 98 of active immunity, 230-232 of antibodies, place of, 269 of aromatic compounds, 99 of enzymes, 109 of esters, 98 of gas, 98 of heat, 104 of light, 99 of pigment, 100 of toxins, 114 Prophylaxis, 264 Protamin in bacteria, 73 Protease, 112 Protective inoculations, first, 28 Protein immunity, 265, 267 split products, 266 Proteins, putrefaction of, 91-97 Proteus, introduced, 30 Protoplasm, 39 Prototrophic, 75 Protozoa related to bacteria, 37 Pseudomonas, 59 pyocyanea, 116, 242 radicicola, 106 Ptomaines, 92 Puecinia graminis, 25 Punctiform colony, 206 Puncture cultures, 169 Pure culture, 157 methods of obtaining, 178-183, Purin bases in bacteria, 73 INDEX Putrefaction, 25, 91 and fermentation, 28 of proteins, 91-97 Q Quick lime as disinfectant, 146 Quinsy, 223 R RaBiEs, 226 Pasteur tréatment of, 231 Rabiger’s method of staining, 194 Radiations, 69 Radium, 69 Rashes, serum, 264 Rate of division, 80 of movement in bacteria, 42 Rats as carriers, 220 Rattlesnake, 252 RayEr, 26 Reaction, anaphylactic, use of, 268 mallease, in glanders, 246 of medium, 70 surface, 81 Reactions, biochemical, definition of, 76 Reavumvr, 30 Receptor, 238 Receptors, 235, 236 free, 237 of the first order, 239 of the second order, 242, 247 of the third order, 248, 250 Recurrent fever, 27” Red corpuscles, 997 Revi, FRaNcESco, 18 Reducing actions, 101 enzymes, 113 Relapses, 216 Relationships of bacteria, 30 Renucct, 25 Resistance of spores, 47 Retarder, 131 Rheumatism, 223 Rhizoid colony, 206, 208 edge, 208 Rhodobacteriacee, 60 Ricwet, 264 Ricin, 239 Rimpav, 257 285 RInpFLEISCH, 27 Ringworm, 26 Ripening of cheese, 29 of cream, 86 Robin, 239 Rock, phosphate, 103 Rods in blood, 26 Roacerrs, 242 Rooms, disinfection of, 153 Root tubercles, 105 RosEnav, 264 Rot, potato, 26 Roup, 223 Rovx, 28 Rust, grain, 25 5 Saccate liquefaction, 205 Saliva as path of elimination, 226 Salivary glands, 226 Salt rising bread, 84 Saprogenic, 91 Saprophilic, 92 Saprophyte, 76 Sarcina, 29, 54 lutea, 67 Sarcoptes scabiei, 25 Sauer kraut, 87 Scarlet fever, 224, 226 Scavengers, bacteria as, 95 Scuick, 264 Schistosomum hematobium, 26 Schizomycetes, first used, ’30 ScHGNLEIN, 25 Scuésine and Mintz, 30 ScHROEDER and Duscu, 20 experiment, 20, 21 ScHuLtze, 20 experiment, 20 Scuwann, 20, 29 experiment, 20, 21 Sea, bacteria in, 61 ~ Sealing air-tight, 19 Second order, receptors of, 242, 247 Secondary infection, 216 Selective media, 182, 183 Sensitization, 265 Sensitized, 265 vaccine, 232 Septicemias, hemorrhagic, 225 Serum, antitetanic, 240 blood, necessity for diluting, 244 286 Serum, diphtheritic, 240 heated, 248 rashes, 264 sickness, 264, 267 Serum-simultaneous method in im- munity, 231 Serums, cytolytic, failure of, 252 Shape of spore, 46 Sickness, serum, 264, 267 Side-chain theory of immunity, 234 Side-chains, 236 Silkworm disease, 25, 26 Size of bacteria, 37 Skatol, 93 Skin as channel of infection, 222 diseases, 222 - Slant cultures, 170 Slide, cleaning of, 191 hanging drop, 185 Slope, cultures, 170 Small intestine, 227 Smallpox, 224, 226, 230, 231 vaccine, 231 SmitH, THEOBALD, 264 Snake venoms, anti-, 252 Sneezing, 226 Soap as disinfectant, 148 Sodium hypochlorite as disinfec- tant, 146 Soil, bacteria in, 61 Soils, acid, 70 Solid media, 158 Solution, Gram’s, 192 stock, of stains, 189 Sore throat, 223 Sound, 69 Sour mash distilling, 87 Source of complement, 254 Souring of milk, 29 SPALLANZANI, 19 Specific: amboceptor, 254 chemical stimuli of cells, 235 disease, 215 Specificity of agglutinins, 244 of amboceptors, 250 of location of infective organisms, 227 of opsonins, 257 Spermotoxin, 249 Spherottilus, 60 Split products of protein, 266 Splitting enzymes, 112 of fats, 90 Spirillacee, 60 INDEX Spirilloses, 220, 222 Spirillum, 50, 60 ‘pirosoma, 60 Spirocheta, 60 Spirocheta obermeiert, 27 Spirochete, 50 Spirochetes, 221 Spoiling of canned goods, 48 Spontaneous combustion, 104 generation, 17 Spore capsule, 45 definition of, 48 free, 45 germination of, 45 of anthrax, 27 position of, 46, 47 shape of, 46 Spores, 44 cause of spoiling of canned goods, 48 conditions for formation of, 48 first recognized, 30 formation of, 45 resistance of, 47 staining of, 192 two, in bacterium, 47 Sprinkling filters, 104 Stab cultures, 169 Stables, disinfection of, 153-155 Stain, anilin-fuchsin, 189 gentian violet, 189 aqueous gentian violet, 189 carbol-fuchsin, 189 Gabbet’s blue, 190 Loeffler’s blue, 189 Staining bottles, 190 for cell forms, 195 groupings, 194 Gabbet’s method, 193 Gram’s method, 191 of acid-fast bacilli, 193 of bacteria, 188-195 of capsules, 194 of flagella, 19+ of spores, 192 Ribiger’s method, 194 reasons for, 188 vont of physiological activity, 11 Welch’s method, 194 Zichl-Neelson method, 193 Stains, stock solutions, 189 Standard antitoxin, 241 test. dose, 241 INDEX 287 Standard toxin, 241 Standardization of vaccines, 259, 260 | Staphylococcus, 54 Srarin, W. A., 181 Steam, 122 ae Zpnnaldehyde disinfection, sterilizers, 122 under pressure, 124 Stegomyta, 221 Sterile, 119 Sterilization, 118 and disinfection, practical, 152, 156 discontinuous, 121 Sterilizers, steam, 122 Stimuli, chemical, effect of, 236 of cells, 235 specific chemical, 235 Stock cars, disinfection of, 155 solutions of stains, 189 vaccine, 260 as preventatives, 260 in treatment, 260 piesa as channel of infection, Straight needles, 176 Stratiform liquefaction, 205 Streptobacillus, 52 Streptococcus, 53, 59, 223, 224 Streptospirillum, 52 Streptothrix bovis, 27 Strict parasite, 76 Structures, accidental, 40 cell, 39 essential, 39 Study of bacteria, 157 of bacterium, necessary steps for, of forms, 30 of pathogenic bacteriology, rea- sons for, 217 of plate colonies, 209 of physiology of bacteria, 196-209 Subcutaneous inoculation, 210 Subdural inoculation, 211 Substances, cytolytic, 268 Substrate, 111 Sugar broth, 160 Sulphur bacteria, 94 circulation of, 97 ‘deposits of, 104 uses of, 78 Summary of Ehrlich’s theory of immunity, 237 of immunity, 268 Surface reaction, 81 Surgical instruments, disinfection of, 153 Susceptibility, 216 Symbionts, 76 Symbiosis, 76 Synthetic media, 158 medium, 167 Syphilitic antigen, 254 Syphilis, 215, 226, 227, 253 i T Taprworm, 26 Temperature, 64 Tenia solium, 26 Test, complement-deviation, 253 complement-fixation, 253-255 dose, standard, 241 for enzymes, 111 for toxins, 115 Gruber-Widal, 244 mallein, 267 negative, 255 positive, 255 tuberculin, 267 Wassermann, 253 Widal, 244 Testicle, 227 Tetanus, 214, 218, 222, 227 Tetracoccus, 54 Tetrad, 54 Texas fever, 214, 215, 220 THaEr, 29 Theories of immunity, 234 Theory, cellular, of immunity, 234 chemical, of immunity, 234 contagium vivum, 23, 24 Ehrlich’s, of formation of precipi- tins, 245 of immunity, fundamental principles of, 235 summary of, 237 exhaustion, of immunity, 234 for use of vaccines, 261 mosquito, of malaria, 24 noxious retention, of immunity, 234 of anaphylaxis, 266 of formation of agglutinins, 242 288 Theory, phagocytosis, of immu- nity, 234 side-chain, of immunity, 234 unfavorable environment, of im- munity, 234 Thermal death-point, 65 determination of, 198 Thermophil, 65 Thiobacteria, 60 Thiothrix, 60 Third order, receptors of, 248-250 Thread, 52 Thrush, 25, 223 Ticks as carriers, 220 Titration, 160 Tonsillitis, 223 Tonsils, 227 as channels of infection, 223 Tovissant, 259 Toxin, 227, 238 final test for, 115 standard, 241 T one a enzymes compared, 114, characteristics of, 114, 115 _ other than bacterial, 115 production of, 114 true, 116 Toxoid, 239 Toxophore group, 250 Tract, alimentary, as channel of infection, 225 TRAUBE, 248 Treatment of rabies, Pasteur, 231 stock vaccines in, 260 Treponema pallidum, 224 Trichinella spiralis, 26 Trichinosis, 26 Trichophyton tonsurans, 26 Tropical dysentery, 27 True toxins, 116 Trypanosomes, 221 Trypanosomiases, 220, 222 Tubercle bacilli, chemical analysis of, 74 Tubercles, root, 105 Tuberculin test, 267 Tuberculosis, 215, 223, 224, 225, 226, 227 due to bacteria, 28 infectious nature of, 26 Klencke’s experiment, 26 Villemin’s experiment, 26 Tuberculous milk, 226 INDEX Tubes, culture, 168 deep, 174 fermentation, 168, 174 Vignal, 173 Two spores in bacterium, 47 TYNDALL, JOHN, 23 Tyndall’s box, 22, 23 Typhoid fever, 214, 226 transmission by flies, 220 U ULTRAMICROSCOPIC organisms, 215 Ultra-violet rays, 138 Unfavorable environment theory of immunity, 234 Unit, definition of, 241 of antitoxin, 241 Unorganized ferments, 114 Unwashable articles, disinfection of, 155 Urea, decomposition of, 95 Urease, 113 Urethral discharges, 226 Urine as path of elimination, 226 bacteria in, 62 Use of agglutinins, 243, 244 of anaphylactic reaction, 268 Uses of carbon, 77 of food, 75 of hydrogen, 78 of iron, 78 of nitrogen, 78 of oxygen, 77 of phosphorus, 79 of precipitins, 246 of sulphur, 78 of vaccines, theory of, 261 Vv VACCINATION, 231 Vaccine, 231 anthrax, 231 autogenous, 260 . bacterial preparation of, 259, 261 black-leg, 231 mixed, 260 polyvalent, 260 preservative in, 260 sensitized, 232 smallpox, 231 Vaccine, stock, 260 Vaccines, bacterial, 258 dosage of, 262 failure of, 261 in general infections, 261 in localized infections, 261 standardization of, 259, 260 stock, as preventatives, 260 in treatment, 260 theory for use of, 261 Vacuoles, 41 Vaginal discharges, 226 Value of opsonic index, 258 Varo, 23 VauGHan, 266 Vehicles, disinfection of, 155 Venoms, antisnake, 252 Visore, Eric, 24 Vibration, mechanical, 69 Vibrio, 50 introduced, 30 Vignal tubes, 173 VILLEMIN, 26 Villous growth, 204 Vinegar, 88 Virulence, 216 Virus, filterable, 216 Vultures as carriers, 220 Ww Watt, cell, 39 composition of, 72 Washable articles, disinfection of, 155 Washing of leukocytes, 257 Wassermann test, 253 Water, bacteria in, 61 filtration, 141 Wess and Barser, 231 WBEIGERT, 28, 235 INDEX 289 Welch’s method of staining, 194 Whooping-cough, 224 Wipat, 242 test, 244 Widal-Gruber test, 244 Will o’ the wisp, 94 Wine, pasteurization of, 129 Winocrabsxy, 30, 60 Wire baskets, 168 nicrome, 177 WOLLSTEIN, 24 Woronitn, 27 Wound infection, 25, 27, 215 caused by bacteria, 27 Wriaut, 256 x X-rays, 69 Y Yast, 29 relation to bacteria, 34 Yellow fever, 221 Z Zansz, Hans and Zacuarias, 18 ZENKER, 26 Ziehl-Neelson method of staining, 193 Zooglea, 41 Zootoxins, 116 Zymase, 113 Zymases, 113 Zymogen, 113 Zymophore group, 239, 247, 250 he se : . 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