HIDEYO NOGUCHI 481 



lapsing fevers are distinct species, and that both in turn differ from the African tick- 

 fever spirochetes, of which he also distinguished two species. The American strain 

 was called by him 5. novyi; the European, S. recurrentis; the West African, S. duttoni 

 (as first proposed by Novy and Knapp); and the East African, S. kochi. Strong,' 

 however, was able to distinguish only two species, recurrentis and duttoni. Bates, 

 Dunn, and St. John' regard relapsing fever of Panama as a distinct disease and call 

 the parasite T. neotropicalis. The species causing relapsing fever in Venezuela and 

 in Spain have been named T. venezuelense and T. hispanicum, respectively.-' 



SPIROCHETES OF THE MOUTH AND RESPIRATORY TRACT (fIGS. IOI-Ii) 



A number of types of spiral organisms occur in the human mouth, their abundance 

 and variety depending on the condition of the mouth and the locality from which 

 the material is obtained. In unclean or diseased mouths the number of spirochetes 

 present is often very much increased, but whether any of them bear a relation to the 

 diseased condition has not yet been adequately demonstrated. 



It is not easy to separate and classify the mouth organisms. There are apparent- 

 ly two large types {Treponema buccale [Figs. 101-2] and Treponema vincenti [Fig.ioi]), 

 one of intermediate size (Treponema macrodentium [Pigs, 107-8, no]), and at least 

 four small types {Treponema microdcntiiim [Figs. 104-5, 109)) Treponema miicosum 

 [Fig. Ill], Treponema deutium or orthodontmn of Hoffmann, and Treponema skoliodon- 

 tum of Hoffmann [Fig. 106]). In addition, the normal mouth may contain a leptospira 

 {L. trimerodonta Hoffmann). 



Of all the mouth spirochetes, Treponema vincenti^ is the most discussed. It is high- 

 ly flexible, and active, has three to six rather flat and irregular curves, and sharply 

 drawn ends, belonging to the refringens rather than to the pallidum type. In quies- 

 cent forms the curves are more regular. The length and general features are about 

 the same as those of T. recurrentis, except that vincenti is perhaps thicker. 



Whether the spirochete of Vincent is etiologically related to the ulcerative process 

 or is only an associate like the other organisms found in acute inflammatory condi- 

 tions has never been determined. It is found in the normal mouth in small numbers, 

 but in ulcerative stomatitis (Vincent's angina) it occurs in abundance. It has been 

 noticed that it is usually associated with the fusiform bacillus, and many believe that 

 the symbiosis is responsible for the diseased condition. Both can be cultivated by 

 anaerobic culture methods on serum agar (Tunnicliff).^ 



Vincent's spirochete {^Treponema schaudinni, q.v.) is also present in certain 

 types of tropical ulcers and has been described as occurring in the sputum in some 

 forms of bronchitis and in the lung tissue in pulmonary abscesses and pulmonary 

 gangrene. 



Treponema buccale (Figs. 101-2) is a long, thick organism with definite double 

 contour and flat curves, wide apart; it is not unlike Treponema rej'ringens, which is 

 a normal inhabitant of the genitalia. 



' Strong, R. P.: United Fruit Co. Med. Dcpt., 14th Ann. Rep., p. 216. 1925. 



^ Bates, L. B., Dunn, L., and St. John, J. H. : loc. cit. 



^ de Buen, S.: Ann. dc parasitol., 4, 185. 1926; Bidl. Acad, de med., Paris (3d ser.), 95, 294. 1926 



■•Blanchard, R.: Arch.f. parasitol., 10, 129. 1906. sTunnicliff, R.: loc. cit. 



