townsend: asexual stages of verruga organism 663 



''Oroya fever" (fever phase of verruga), while they consider 

 ''verruga peruviana" (eruptive phase of verruga) to be a distinct 

 disease. It is the purpose of the present communication to in- 

 terpret correctly the stages in the asexual cycle of the patho- 

 genic organism from the findings already published, the signifi- 

 cance of which has not yet been fully pointed out. These 

 published findings will be taken up in chronologic order. 



In 1911, Darling figured gametes found by him in verruga blood 

 smears from Peru, among which he gives a figure of an erythro- 

 cyte filled with minute rods which he terms "young x-bodies," 

 and which will be referred to as Darling's x-bodies.^ These are 

 the immature gametes of Bartonella, shortly after penetration of 

 the erythrocyte. 



In September, 1912, Gastiaburii and Rebagliati, working in 

 Lima, Peru, discovered certain "cuerpos" (bodies) in verruga 

 eruption tissue and in liver of verruga patients in the eruptive 

 phase, which they figured and described as Leishmania-Uke.* 

 These "cuerpos" are respectively early and maturing schizonts of 

 the Bartonella before they have begun to break up into merozoites. 



In April, 1913, Mayer, Rocha-Lima and Werner, working in 

 Hamburg, figured and described certain "Zelleinschliisse" (cell- 

 inclusions) which they found in vascular endothelial cells of the 

 greater part of the verruga nodules examined by them from a 

 case of the disease just arrived from Peru.^ Their figures 1 to 4 

 show the cell-inclusions entire, while 5 and 6 show them rup- 

 tured. These "Zelleinschliisse" are evidently to be interpreted 

 as, respectively, maturing Bartonella schizonts (1 to 4), and 

 Bartonella merozoites which have resulted from the breaking up 

 of schizonts (5 and 6). 



In 1915, Strong et al. figured and described certain "spheres" 

 found by them in endothelial cells of spleen and lymphatic nodes 

 of verruga patients in that phase of the disease which they term 

 "Oroya fever," which spheres they state apparently "break up 



3 Proc. Canal Zone Med. Assoc. 4: 208-209. (No. 6, Case I, right-hand figure.) 

 1911. 



* Cr6nica Medica, 29: 651. 1912; Journ. Econ. Ent., 6: 224. 1913. 

 6 Munch. Mediz. Wochenschr. 60:740. April, 1913. 



