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1. Those with clinical diphtheria (more or less severe), with
Klebs-Lœffler bacilli in their throats or noses (or both).
2. Those with nasal catarrh and faucial redness (or sub-acute
tonsillitis), with Klebs-Lœffler bacilli in their throats or
noses (or both);
3. Those with no clinical symptoms whatever, but showing
the presence, on examination, of Klebs-Lœffler bacilli
in their throats or noses (or both).
The diphtheria bacillus is undoubtedly polymorphic, and
variable in virulence according to environment (e.g., state of
mucosa).
The different diphtheria bacilli found in connection with the
Outbreak may be classified as follows:—
1. True Klebs-Lœffler.—Delicate, slender, even rods of
ing lengths from 3 to 5 u (long, short, and medium),
and of 1 u in thickness; non-motile; non-sporing; staining
with methylene blue (Lœffler), segmentally and
polarly, and with Gram's and Neisser's methods,
characteristically; with a tendency to arrange themselves
in parallel groupings; acid reaction with glucose;
virulent to animals (i.e., lethal to guinea pigs with loss
of weight); affected by antitoxin.
2. Involuted or modified forms of
shaped, and club shaped rods; staining irregularly (i.e.,
not distinctly segmentally and polarly) with methylene
blue (Lœffler), and only occasionally with Gramm's and
Neisser's methods; slight acid reaction with glucose;
non-virulent to animals (i.e., not lethal to guinea pigs
but simply causing in them local swelling without loss of
weight); unaffected by antitoxin.
3. Hoffmann or pseudo-diphtheria.—Short, even rods, staining
evenly with methylene blue (Loeffler), and not at all
characteristically with Gramm's or Neisser's methods; no
acid reaction with glucose; non-virulent to animals
(i.e , not lethal to guinea pigs but simply causing in
them local swelling without loss of weight); unaffected
by antitoxin.
These three different classes were found (a) in pure cultivation,
or (b) mixed (in varying proportions), one with the other.