THE reccnt studies of Rarratt (1933) and of Petrio and McClean (1934) have emphasised that members of the genus Corynebacterium other than C. diphtherk may be pathogenic for man. That such organisins may be found associated with epidemic disease is suggested by the observations of Gilbert and Stewart (1928-29) who described three outbreaks associated with milk infection traced to carriers of a diphtheroid bacillus which they named C. ulceram. The clinical condition was not of the same mild type as bacteriological diphtheria " as was shown by the fact that one case proved fatal with extensive lesions in the throat. Schultz et al. (1933-34) havc observed a case which throws yet another light on the pathogenicity for man of the diphtheroid bacilli, the infection being en invasion of the meninges by a previously uiidescribed type which they name C. parwulum. The present paper describes fat,al case of meningitis due to an organism resenibling that described by Schultz and his co-workers. It is of interest because the lesions produced appear to have resulted from invasion by a non-toxigenic typo of diphtheroid bacillus. Report of m e .Labourer engaged in bridge building. No history of trauma. Onset, 28.10.34, with shivering, malaise and gcnerdisetl pain in body and limbs. Pationt was seen by his medical tittendant the following day when his temperature wm 100.4" F. but no locnlising signs were present. Faeces nnd urine passed, no vomiting. Temporature 103, pulse 78, respiration 24. By the cvaning of the same day the patient's condition had deteriorated, tcmpcratiire being 104.6, pulse 84 and respiration 30. Rigidity of back muscles was present ; patient sent to hospital. On admission, 31.10.34 (4th day of illneM), ptxtiont very distressed and rather delirious, with some neck rigidity : Kornig's sign strongly positive : Brudzinski's sign positive. Clinical hktvry. E. F., aet. 37. 31.10.34. Loss of power on right side, notably hand and arm. 299 240 H . J . GIBSON 1.11.34. Temperature 105. Pulse 104 rising to 128. Rcspiration 36 rising later to 48.Lumbar puncture performed, thc fluid being clear and under reduced pressuro (40 drops per minute). Some improvement in goncral condition followed lumbar puncturu.The patient died the following day with hyperpyrexia. His condition rendered physical examination diflicult, but throughout the coupso of the illness physical sigm of edema at both lung bases were observed. Tho duration of illnoss was thus 6 days. W.B.C. 12,300.Autopsy. Along the vertex of the brain there was considerable thick purulent exudate extending laterally over the superior surfaces of the hemispheres. Base free of pus. Cerebrospinal fluid turbid. Brain substance showed little change, slight congestion underlying the inflamed meninges. No evidence of any abscess. Both middle ears and the sphenoidal, ethmoidal and frontal sinuses were free from evidence of infection. Lungs congested and cedematous at both bases. The remaining viscera presented the changes associated with fever and non-specific toxsinia. BACTE...

1. A study has been made of natural agglutination as exemplified by the reactions of the serum of nine animal species with a variety of bacteria.2. End-titres are recorded, and the fact is noted that sera of different animal species show an order of agglutinating activity which is almost constant for all organisms used. Ox, pig and horse sera give consistently strong reactions, while specimens from rabbit, guinea-pig and rat react weakly or not at all. Sheep, human and cat sera occupy an intermediate position. Variations are noted, however, with different individual specimens of serum from the same species.3. Organisms of the series tested can also be grouped in order according to their apparent susceptibility to agglutination by normal sera.4. The serum of young animals is found to be deficient in the agglutinating principle.5. The agglutinating effect shows a thermolability intermediate between that of complement and the immune agglutinins. Complete inactivation occurs as a rule after exposure to 60° C.–65° C. for half-an-hour. For certain strains the serum principle is inactivated at much lower temperatures.6. Lability curves show marked irregularity. In certain cases a zone of relative inactivation is produced at a temperature of 55° C.7. The natural agglutinating substance is found to be present in greater degree in the carbonic acid insoluble fraction of serum than in the carbonic acid soluble fraction. In this respect it differs from the immune agglutinins, which are chiefly located in the carbonic acid soluble moiety.8. The agglutinating principle for each organism can be absorbed completely by the homologous strain, when a variable lowering of the end-titre for other unrelated organisms results. A similar lowering of activity for these organisms may be produced by treating the serum with non-specific physical absorbents. Charcoal and Kieselguhr were used to demonstrate this.9. By the technique of double absorption it can be shown that agglutination depends on non-specific and specific factors and it is concluded that normal serum agglutinates bacteria in virtue of a twofold mechanism:(a) A non-specific effect reacting in varying degree with all organisms and removable by treatment with a finely divided absorbent.(b) A series of specific effects reacting as true “natural antibodies.” These specific antibody-like principles exist for a wide variety of organisms. Absorption of any one organism removes the homologous effect leaving the remainder quantitatively unimpaired.10. The question of bacterial variation and receptor analysis in relation to the natural agglutinins is being studied and will be reported on at a later date.

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