ROUTINE DIPHTHERIA EXAMINATIONS.

A study of the table of examinations will show that the work has not decreased when that being done at Owatonna is included, and excluding this for the quarter it will be found to be much greater than for any other quarter in the history of the laboratory

in which a similar exclusion is made, even whilst the diphtheria diagnostic work was being done for the city of Minneapolis in this laboratory. A new feature in the preservation of the records of the examination of specimens is the employment of a card of the size and description indicated on page 447.

These cards are filled in daily as soon as examinations are completed, and are an index of the danger of contagion from the case. They are kept in a box, like a card catalogue, alphabetically arranged according to patients' names while such cases are under observation, and make a cross reference to the ordinary filing envelope where the filing is by case number and date.

The necessity for interpreting the diagnosis given has been long apparent, and the plan outlined in Circular of Information No. 2, has been adopted.

The copies of the diagnosis (made in quadruplicate) which go to the local health officer and the attending physician are made upon blanks, on the backs of which are printed the possible interpretations of the diagnosis given. Those copies kept in the laboratory, as well as those sent to the secretary of this board, have not such printing on the back. (See page 190.)

As has before been pointed out, the number of examinations is not an indication of the number of cases of dipththeria occurring in the state, since the bacteriological method is not universally employed for diagnosis. And where the first case is reported upon negatively, further examinations are not asked for nor made. This is often a mistake on the part of the physician, since his method of collecting and forwarding the specimen may have been faulty, when they are evolved by himself, or he too frequently employs boxes for the transmission of specimens which, from the age of the medium contained, are not suitable.

RABIES.

Notwithstanding the fact that no specimens have come in for diagnosis, it must be remembered that the inoculation of a pair of rabbits occurs every ten days in order to maintain the "fixed" virus.

The inoculations begun from the brain of the mad wolf sent in from Cannon Falls last winter (Case No. 26) have been continued through the necessary series of rabbits in order to obtain, if possible, a fixed virus from this source. The incubation of thirteen to fourteen days at first observed became lengthened, and is still much greater than at first.

The inoculations in these two series are continued in the hope of being able to work out a serum therapy, and to study the relation, if any, of the subcutaneaus inoculation on the development or arrest of infection by means of subdural inoculation.

Dr. Geo. Douglas Head, of the University of Minnesota, is mak ing a count of the blood, particularly in regard to leucocytosis, in the animals used, both before and after inoculation.

CEREBRO-SPINAL MENINGITIS.

Material secured by lumbar puncture in one case of cerebrospinal meningitis was examined in the laboratory during the past quarter. Only one pair of diplococci were found in the several coverslip preparations direct from the fluid. Cultures and guinea pig inoculations have been made, and the matter is still under investigation.

GLANDERS.

Dec. 18, 1898, material for histological and bacteriological examination was obtained from a horse and a mule killed at the State Experimental Station, on a diagnosis of glanders by the director of the veterinary department of this board. B. mallei was obtained in purity from the cervical glands in the first cultures made, and by guinea pig inoculations from the same substances. The histological material has not yet been examined.

EXAMINATION OF URINE.

On Dec. 20, 1898, there was received in the laboratory a specimen of urine from Dr. A. W. Abbott, of Minneapolis. The somewhat unusual clinical history suggested that this might be an interesting case to investigate concerning the diagnosis between B. tuberculosis and the smegma bacillus, about which there has recently been much discussion, and an examination was undertaken. The patient, a young woman, though in fairly good general health, had shown pus in her urine for more than ten years. This had been examined microscopically a number of times for tubercle bacilli, but always with negative results. The pus had been shown to come from the left ureter only. The specimen brought to the laboratory had been drawn with a catheter, with ordinary aseptic precautions, into a sterile flask, and kept in a cool place until examined, twenty-four hours later.

After centrifugalizing, four smears were stained in the ordinary way for tubercle bacilli, and three for smegma bacilli, with

out the use of alcohol. Only very numerous bacilli, slightly larger than tubercle bacilli, were found. These were quite uniform in size and shape, and invariably stained blue.

Cultures in various media all gave a heavy and pure growth of a bacillus, which, on further examination, proved to be B. coli communis.

One guinea pig inoculated subcutaneously with the urinary sediment died on the fourth day, and from the seat of inoculation B. coli communis was isolated in pure culture.

Another specimen of urine has been asked for, and further examinations will be made to determine whether or not there be a causative relation between B. coli communis and this chronic case of pyelonephritis.

SUBDURAL INOCULATION OF DIPHTHERIA BACILLI.

The studies on the subdural inoculation of diphtheria bacilli which were begun last winter, and laid aside in the spring on account of the pressure of other work, have been recently resumed. As a preparatory step, the virulence of several of the stock cultures of B. diphtheriae in the laboratory was tested by subcutaneous inoculations into guinea pigs. In the three that were used a year ago no change was observed.

When the virulence by subcutaneous inoculation had been determined, guinea pigs were inoculated subdurally by the ordinary trephining operation, in varying minute doses. One of the animals, on the eighth day, developed a posterior paralysis, which rapidly ascended and produced death in about seven hours from its onset. At the autopsy, marked general meningitis was present, and B. diphtheriae was recovered in pure culture from the surface of the meninges.

The next step will be the subcutaneous and subdural inoculation of rabbits with the diphtheria organism. Preparatory to this, Dr. Geo. D. Head, of the State University, is making blood counts. on the normal rabbits, which it is proposed to use for the experi ments. These counts will be continued after the inoculations are made, in order to determine the presence or absence of leucocytosis.

DISINFECTION EXPERIMENTS.

DISINFECTION OF SCHOOL BUILDINGS AT ALBERT LEA, MINN.

The following abstracts are from the correspondence relating to the tests of disinfection of the school buildings at Albert Lea, Minn.:

Letter to Dr. von Berg from the director of the laboratory of the State Board of Health, dated Nov. 7, 1898:

"Dr. Bracken informs me that you are supervising the disinfection of the Albert Lea schools, and wish for test materials from the laboratory, in order to determine the efficacy of the methods employed. We are accordingly sending you by express this afternoon outfits numbered one to forty-nine. They consist of glass tubes, five-eighths inch in diameter, and three to four inches long (open at both ends), (a) in which the ends are plugged with cotton wool, (b) over the ends of which four thicknesses of gauze are tied.

"In the tubes, which have been sterilized, are cotton threads which have been dipped into cultures B. prodigiosus and B. subtilis. The short ones are B. prodigiosus and the long ones B. subtilis. using these outfits for your tests, I would suggest that:

In

"(1) In all rooms operated upon, one tube he placed in the following way: -, allowing it to lie upon its side, the cotton wool plugs may be withdrawn and left close to the ends of the tube from which they have been taken. This will determine the action of the materials directly upon the threads.

"(2) In certain of the other rooms to be selected by you "(a) Place the tubes just as they are (of course, after unwrapping the paper). This will determine whether the agent employed is capable of passing through cotton wool or not.

"(b) The tubes covered with the gauze may also be placed just as

they are after unwrapping.

"In certain of the rooms you will be able to obtain information as to whether the agent employed permeated the four thicknesses of gauze. In making your returns to us with the numbered outfits, please give us the following data, in full, and as much more as seems to you desirable: The size, situation, number of windows in, character of the walls, floors, etc., of the room; the amount of material employed, and how long it was allowed to act.

"We shall probably not be able to report for three or four days after the receipt of the tubes, as the bacteria may be affected in such a way as to cause the growth to be slowed, though they may not have been absolutely killed, and we would wish time to settle this matter. Of course, in those tubes from which the plugs have been removed by you it will be necessary for you to replace them and to wrap again in paper. Wrap each of the outfits in paper, so as to prevent breakage and possible accident in the removal of the plug in transit. Of course, you will see the necessity of our know