188 REVIEW — TEOl'ICAL MEDICINE, ETC. 



Spirochaetes Leishman,' reviewing papers read at the Berlin International Congress of Hygiene, gives 



and Spiro- DoHein's views. The latter regards present staining methods as inadequate for pathogenic 



chaetosis— spirochastes, and has not much belief in the reputed presence of a blepharoplast. He thinks 



contiimed spirochtetes vary as to their mode of multiplication, and he is inclined to class them in a 



special group, midway between the animal and the vegetable kingdoms, for which he suggests 



the name " Proflagellata." Levaditi pointed out that all the pathogenic spirochtetes, except 



those of syphilis, yaws and a dermatosis of the pig, are the cause of true septicaemias. He 



thought their protozoal nature had not been proved, but was inclined to attach some 



importance to the reported discovery of peritrichic flagella in >S'. galUuarum and 6'. duttoni. 



As regards the mechanism of relapses, Levaditi held to the opinion long ago expressed 

 by him that the crisis is due to phagocytosis of the spirochaatte and their intra-cellular 

 digestion, and not through the action of specific anti-bodies, which only make their appearance 

 in the blood after the crisis is over. He pointed out that the spirochsetae did not, however, 

 disappear entirely from the blood during the interval {see, however, special paper on 

 " Spirochsotosis of Fowls," Third Eeport), but that a few could always be found on careful 

 search. He believed that such spirocliistEe as had escaped destruction during the crisis had 

 become immune to the action of the anti-bodies, and in this way were able to multiply and 

 produce a second attack. 



He had found that such immune spirilla were able to transmit their powers of 

 resistance to their progeny, because relapse-spirochaetae were found to preserve their 

 resistance after several passages through susceptible animals. 



Vaccination can easily be produced in animals by the injection of killed spirocheetse, or 

 of a non-lethal dose of living organisms. Preventive serum-therapy is also possible, 

 because the serum of animals which had recovered was found to be strongly bactericidal and 

 agglutinative. 



The reader may also consult a short French paper by Borrel,- which discusses the 

 relationship of the spirilla, spirochsetae and trypanosomes, and gives illustrations of 

 the terminal flagella in S. gallinarum and the so-called undulating membrane of S. halhiani. 



Passing from these more or less general papers, we may first consider papers on African 

 Spirochaetosis, then take up the Indian, European and American varieties, in each instance 

 citing observations as regards the vector, the parasite, the clinical symptoms, preventive 

 measures and treatment. 



Koch's' observations are thus summarised in the Medical Annual, 1907. He notes with 

 regard to the habits of Ornithodoros moubata, which transmits the spirochsete (S. duttoni) 

 of African tick fever, that it is exclusively a human tick. It is nocturnal in its habits, and 

 after sucking blood, quickly hides again in the earth of the native huts or rest-houses. It 

 likes dry soil, and in fact, if the earth is moist (as is the case when goats are brought inside 

 the hut at night) no ticks are to be found. The African tick fever differs clinically from the 

 European lapsing fever (S. obermeieri) in the following points. In the European form 

 the first attack lasts six to seven days ; then follows an apyrexia of five to six days, then a 

 second somewhat shorter attack and a longer apyrexia of five to six days, then a second 

 somewhat shorter attack and a longer apyrexia, and so on. In the African form, the 

 maximum duration of the attack is three days and the apyrexia six to ten days. Again, in 

 the African form the number of parasites may be extremely scanty, and thus difficult to find. 

 It is advisable always to make a smear as large as a sixpence, dry thoroughly, 

 dehaemoglobinise with water (without fixing), and then stain with gentian violet, five to 

 ten minutes. 



Koch has found spirochetes in about a quarter of the eggs up to the twentieth day 

 of development of ticks which had sucked spirochmte blood. They can then be seen no 

 longer, but must exist, as young ticks carry the infection. It is probable, indeed, that 

 ticks in the young stage are by far the most infective (though adults also may convey the 

 disease). Koch found infected ticks to occur in practically every hut examined, in a 

 variable proportion, e.g. 7 to 50 per cent. In the huts, however, there are frequently no 

 natives sufi'ering from spirochaete fever. The question, therefore, arises, how do these ticks 

 get their infection ? Various hypotheses are possible, of which only one may be mentioned 

 here, viz., that rats contain spirochaetes, and that they may act somewhat as rats do in 



' Leishman, W. B. (April, 1908). Journal of the Royal Army Medical Corps, Vol. X. 



^ Borrel, A. (March 2nd, 1908), " Spirilles, Spirochetes, Trypanosomes." Bull. Soc. Path. Exot., Vol. I. 



' Koch, R. (February, 1906). Berl. Klin. Woch. 



