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George V. Taplin, M.D.; George R. Meneely, M.D.; Robert A. Hettig, M.D.
JAMA. 1938;111(5):410-411. doi:10.1001/jama.1938.72790310001010.
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In the routine use of the quellung (swelling) reaction for the rapid typing of pneumococci in sputum, certain difficulties are encountered frequently which delay the process of typing and impair its accuracy. These may be enumerated as follows: 1. In some specimens of sputum pneumococci are rare so that considerable time is consumed in making sure that no quellung occurs. 2. The presence of cells and detritus frequently makes it difficult to recognize pneumococci and delays the process of quellung for from ten to thirty minutes. 3. The individual portions of sputum used with each type-specific serum vary greatly among themselves with regard to factors 1 and 2. In view of the large number of types to be determined and the fact that more than one type of pneumococcus may be present in a given specimen, considerable time may be required before a complete report can be rendered. For this


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