═════════════╤═════════╤══════════╤════════════╤═══════════════════════ │ BED │ │PNEUMOCOCCUS│ NAME │OCCUPIED │ ADMITTED │IN SPUTUM ON│ SECONDARY INFECTION │ │ │ ADMISSION │ ─────────────┼─────────┼──────────┼────────────┼──────────┬──────────── „ │ „ │ „ │ „ │ DATE │PNEUMOCOCCUS │ │ │ │ │ AT AUTOPSY ─────────────┼─────────┼──────────┼────────────┼──────────┼──────────── Pvt. Pighee │No. 48 │Sept. 22 │Atyp. II │ │ Pvt. Jones │No. 49 │Sept. 22 │Atyp. II │ │ Pvt. Lewis │No. 50 │Sept. 21 │I │Oct. 2 │Atyp. II Pvt. Scott │No. 51 │Sept. 21 │Atyp. II │ │ Pvt. Columbus│No. 53 │Sept. 22 │Atyp. II │ │ ─────────────┴─────────┴──────────┴────────────┴──────────┴──────────── It is noteworthy that these instances of secondary contact infection with pneumococci occurred in wards where every precaution was supposedly taken to prevent transfer of infection from one patient to another. It is true however that the wards were greatly overcrowded at the time. Many other instances of secondary pneumococcus infection in cases of pneumonia following influenza were encountered in which it was impossible to trace the source of infection, many combinations of different types of pneumococcus being found. There were two instances in which Pneumococcus Type IV was found in the sputum by inoculation of white mice shortly after onset of pneumonia, whereas secondary infection with other types was found at autopsy, one with Pneumococcus Type II, one with Pneumococcus Type III. In 2 cases by inoculation of white mice, two types of pneumococcus were found simultaneously in the sputum coughed from the lung, in one Pneumococcus Types III and IV, in the other Pneumococcus Types I and IV. There were 5 cases in which two types of pneumococcus were found in cultures at autopsy as shown in Table XXIV. Combined pneumococcus infections of this nature are almost never encountered in pneumonia occurring under normal conditions in the absence of epidemic influenza. TABLE XXIV MIXED PNEUMOCOCCUS INFECTIONS IN PNEUMONIA