Studies on Epidemic Influenza: Comprising Clinical and Laboratory InvestigationsUniversity of Pittsburgh. School of Medicine
History
Studies on Epidemic Influenza: Comprising Clinical and Laboratory Investigations
University of Pittsburgh. School of Medicine
Influenza; Influenza Epidemic, 1918-1919
The use of symbiotic bacteria has been extensively studied in
investigations of the biology of B. influenzæ, and it has been shown, as
noted elsewhere, that such accessory bacteria will bring to growth B.
influenzæ on media otherwise quite unsuited to its needs. It has been
further found that on various preparations of hematin agar, on which B.
influenzæ refused to grow, such media could be rendered favorable for
their growth by the addition of living or freshly killed cultures of
staphylococcus and many other bacteria. And although the method is well
known, it has not been extensively used for the purposes of isolation.
Many of the workers, however, have pointed out the importance of looking
for growth of the influenza bacillus in the neighborhood of the more
easily grown bacteria which almost always develop in cultures from the
respiratory tract. Grassberger has particularly studied this problem and
has made practical application of the method. Accidental contamination
of plates with air bacteria have made possible, in some instances, the
isolation of B. influenzæ—as, for example, in the finding of Heyrovsky
from a case of empyema of the gall bladder—while other workers have
pointed out the difficulty of demonstrating growth where B. influenzæ is
pure in the material cultured, and the comparative ease and relative
luxuriance of growth where other bacteria are present. To just what this
stimulating effect is due has been much discussed, and it is generally
agreed that the hemoglobin is markedly changed and rendered more
available by the action of these germs. It is to be noted that on a
medium containing blood altered by heating or by the various methods as
described by Fleming the foreign bacteria no longer show any symbiotic
action on B. influenzæ. Grassberger considered the effect of the
bacteria on the blood to be the same as that of heating. Allen laid
particular stress on this symbiotic character. He used a staphylococcus,
either living or killed, in making his cultures and noted the difficulty
of growing B. influenzæ from material in which it occurred pure. W. F.
Robertson made use of these facts of symbiosis for both isolation and
stimulation of growth. He employed alternate drills of M. catarrhalis or
pneumococcus with the B. influenzæ, and Brown and Orcutt used strains of
hemolytic streptococci for the same purpose. The latter authors
considered that the beneficial effect of the streptococci was merely due
to the setting free of the hemoglobin. The fact that similar results are
to be obtained by the use of non-hemolytic bacteria as well as forms
giving green color changes to the blood makes this explanation
untenable. In my own studies I have confirmed the results of several
previous workers. I have found that B. influenzæ is stimulated in its
growth by the presence near it of colonies of staphylococcus pyogenes
aureus and albus, pneumococci, streptococcus viridans and hemolyticus
and other bacteria.
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