198 RKVIEW — TROPICAL MEDICINE, ETC. 



SUtning— Herman^ recommends a new staining method for tubercle bacilli, applicable both 



eonlinual to smears and sections. The staining bath is composed of a mordant consisting of a 

 10 per cent. soUition of carbonate of ammonia in distilled water and of a stain, namely, 

 3 per cent, solution of crystal violet in ethylic alcohol at 95° C. 



One part of the stain is added to three parts of the mordant immediately before use and 

 the solution well mixed. Decoloration is effected by a 10 per cent, mixture of nitric acid 

 in ethylic alcohol at 95° C. 



MacNeal-* has introduced a rapid and simple method of staining Spirochagta pallida, 

 with the following solution : methyl violet 0-25, medicinal methylene blue 0-10, eosin 0-20, 

 methylic alcohol pur. 100. Dissolve, aiding solution by warming. The film to be stained is 

 covered with the undiluted solution for 45 to 60 seconds. It is then inunersed for one or two 

 minutes in 10 c.c. of a solution of sodium carbonate of a strength of 1 part in 20,000. 

 Rinse in distilled water, dry and examine with an immersion lens. The spirochtetes are 

 intensely stained, and retain their colour if mounted in rectified Canada balsam. 



Syphilis. This is a subject of great importance in the Sudan, where the disease is 

 rife, occurring both in mild and severe forms. Its prevalence has already been noted and 

 couimented upon in the First Report of these Laboratories ; but, though of special interest, 

 it is utterly impossible to review more than the merest fraction of the vast number of papers 

 which have accumulated on the subject since the discovery of the Spiruclixta pallida. 

 Indeed it is only the resemblance of syphilis to spirochaetosis and trypanosomiasis, which 

 justifies the brief notice accorded it here. 



Mott,3 in an interesting paper, draws attention to the similarity existing in several 

 respects between syphilis and trypanosomiasis, saying : — 



As showing the analogy with trypanosome infectious, I may mention that it was observed by Lingard that in 

 the Dial flu coil of horses scariflcation of the plaques, which come out in successive crops— commencing forty days 

 after infection— yielded blood and serum containing numbers of trypanosomes, whereas they were found with 

 difficulty in the peripheral blood. Nattan-Larier and Tanon likewise found in the fluid obtained by scarifi- 

 cation of the erythmatous spots in a white person suffering from trypanosomiasis, numbers of trypanosomes, whilst 

 none could be found in the peripheral blood stream. 



In both these diseases the lymphatic glands generally become enlarged, and in sleeping sickness puncture of 

 the swollen glands and examination of the fluid reveals trypanosomes ; so also Jletchnikoff was able to domoastrate 

 the spirochetes in the enlarged glands of the infected chimpanzee. It therefore follows that there is this analogy 

 between the virus of syphilis and the before-mentioned trypanosome diseases — that the protozoon multiplies in the 

 lymph with much greater readiness than it does in the blood ; this may be due to the presence in the blood plasma 

 o"f lysins, similar to the bacteriolysius or hemolysins. Moreover, there is so close a similarity in the reaction of 

 the fixed tissue elements to the presence of the trypanosomes or spirochetes, that either the organisms themselves 

 or the toxins generated by them give rise to a similar hyperplasia characterised by proliferation of the nuclei of 

 the fixed connective tissue cells forming the embryonic cells or lymphocytes, and proliferation of the endothelial 

 cells, forming plasma cells or epithelioid cells. In trypanosome diseases, however, there is no proliferation of the 

 sube'ndothelial cells of the arteries, leading to endarteritis, vascular occlusion, and necrobiosis of the central cells, 

 as in a gumma. It is, moreover, rcmarkalile that, unlike bacterial iitfection, trypanosome affections and syphilis 

 are, if uncomplicated by secondary microbal affections, unattended by polymorphonuclear invasion. 



Leishman^ reviews the papers read on the etiology of syphilis at the Berlin Congress of 

 Hygiene, 1907. He quotes Hoffmann as saying that : — 



For demonstration of the spirochete, Giemsa's stain was best for fresh films and Lovaditi's silver method for 

 sections ; but he pointed out that it was also possible to stain the parasite in sections by Giemsa's stain, and to 

 demonstr.ate them in films by the silver method, if proper precautions as to technique were followed. For 

 diagnosis, he thought the best method was staining by Qierasa, combined with a search for the unstained spirochaetes 

 with dark-ground' illumination. The spirochetes are found chiefly in the connective tissue, in the lymphatic 

 vessels, and in the walls of the blood vessels ; occasionally they are to be met with in leucocytes, hepatic cells and 

 other tissue cells. The conditions found in the blood are not, apparently, favourable to the development of the 

 spirochete, possibly because it is an anerobe. 



Hoffmann believes the spirochsete to be undoubtedly the cause of syphilis, and states 

 that it holds the same diagnostic importance for syphilis as the B. tiiberculunis for tubercle. 

 Zabolony concurs in this view, and he pointed out that the spirochaetes are agglutinated by 

 the addition of serum derived from syphilitic patients. 



' Herman, M. (January 25th, 1908), " Sur la coloration du bacille tuberculeux." Ann. dc VlnslUut Faslewr, 

 Vol. XXII. 



2 MacNeal, W. J. (February IGth, 1907). Jonnial of Urn Ainmcnn Ucrlkal A.isociaiion. 



■'■ Mott, F. W. (.January 4th, 1908), " Au Address on some recent Developments in our Knowledge of Syphilis 

 in Relation to Diseases of the Nervous System." Britl-ih ilnlieal Journal, Vol. I. 



•* Lcishman, W. B. (April, 1908), "The International Congress of Hygiene, Berlin, September, 1907." Journal 

 vf llic Royal Arnvj Utdicnl Corps, Vol. X. 



* Article not consulted in the original. 



