=Autopsy 425.=—Illness began with influenza twenty-nine days before death; a diagnosis of pneumonia was made fourteen days before death. At autopsy there were chronic bronchopneumonia with tubercle-like nodules of consolidation with some large patches of consolidation, multiple small abscesses giving a honey-combed appearance to part of the right middle lobe, purulent bronchitis and bronchiectasis. S. hemolyticus was grown from the heart’s blood; S. hemolyticus, B. influenzæ and S. albus from the lung. Sections of an abscess contain clumps of cocci. An abscess cavity has along one side remains of a bronchial wall covered by squamous epithelium; a dilated bronchus, cut longitudinally, terminates in this irregular abscess cavity. Table XLIX shows the incidence of pneumococci, hemolytic streptococci, staphylococci and B. influenzæ in the foregoing autopsies with abscesses clustered about bronchi: TABLE XLIX ════════╤════════╤═════════════════╤═════════════════ │ NO. OF │ │ HEMOLYTIC │CULTURES│ PNEUMOCOCCI │ STREPTOCOCCI ────────┼────────┼────────┬────────┼────────┬──────── │ │ NO. │PER CENT│ NO. │PER CENT │ │POSITIVE│POSITIVE│POSITIVE│POSITIVE ────────┼────────┼────────┼────────┼────────┼──────── Bronchus│ 4│ 2│ 50.0│ 2│ 50.0 Lung │ 6│ 2│ 33.3│ 3│ 50.0 Blood │ 6│ 2│ 33.3│ 2│ 33.3 ────────┴────────┴────────┴────────┴────────┴──────── ════════╤═════════════════╤═════════════════ │ │ │ STAPHYLOCOCCI │ B. INFLUENZÆ ────────┼────────┬────────┼────────┬──────── │ NO. │PER CENT│ NO. │PER CENT │POSITIVE│POSITIVE│POSITIVE│POSITIVE ────────┼────────┼────────┼────────┼──────── Bronchus│ 4│ 100.0│ 4│ 100. Lung │ 4│ 66.7│ 2│ 33.3 Blood │ │ │ │ ────────┴────────┴────────┴────────┴──────── Staphylococcus shows in the lung the same tendency to produce localized abscesses which it exhibits in other tissues of the body; it invades the lung by way of the bronchi, but shows no ability to invade lymphatics, and in the cases we have examined rarely enters the pleura or the blood. In all of these cases B. influenzæ has been found in the bronchi and perhaps precedes the staphylococcus as an invader of the lower respiratory passages. Pneumococci atypical II, Types III and IV have been found in over half of these cases. The significance of this organism is emphasized by the 2 cases in which it has been found in the heart’s blood at autopsy. It appears not improbable that S. aureus has invaded the lung already the site of bronchopneumonia caused by pneumococci.