366 S. R. GIFFORD 



He mentions Veullar and Zuber's having found such bacilli 

 Gram-positive in material from the appendix. An article by 

 Veillon (1898) describes Fusiformis from the appendix as Gram- 

 negative (p. 540) and I could find no description of it as Gram- 

 positive in his articles. 



In summing up some of the literature on noma, Weaver and 

 TunniclifT (1907) mention that Foote, Elder, Blumer and Mac- 

 Farlane, Hofman, Buday and Nicolaysen all found fusiform 

 bacilli Gram-positive, while in their own case of noma they were 

 Gram-negative, " except in the dark spots," though they held 

 the stain longer than the spirilla also present. In some of the 

 last quoted articles, the description does not sound typical of 

 Vincent's organisms and in most no spirilla were present with 

 them. Dick (1913) in 7 post-mortems of meningitis, cerebellar 

 abscess, gangrene of the lung, pneumonia, empyema, and peri- 

 tonitis, found the fusiform bacilli always Gram-negative. The 

 same was true of the 3 strains which were cultivated. Krumwiede 

 and Pratt, (1913, a, b) of 15 strains from the throat and teeth, 

 found all Gram-negative, in smear and culture. TunniclifT (1906) 

 who cultivated them, found the fusiforms Gram-negative in 

 cultures. 



Altogether of 17 authors or groups of authors who mention the 

 Gram-stain, 6 found the fusiform bacilli Gram-positive, 8 found 

 them Gram-negative, while of the 3 remaining, Foote found them 

 Gram-positive but that care was necessary to avoid decolorizing 

 too much, Hofman, Gram-positive but "care was necessary in 

 differentiation" and Bernheim and Pospichill found them Gram- 

 negative after longer decolorization. 



This disagreement might be due to the fact that entirely dif- 

 ferent organisms of fusiform appearance were present in different 

 cases. In view of the large number of cases of Trench Mouth 

 that we were examining it seemed worth while to test a series 

 of smears against standard Gram staining technique. Unfor- 

 tunately this was not undertaken while the press of work was on, 

 so records are available for a relatively small number of cases. 

 Only cases which showed a profusion of both bacilli and spirilla 

 were included. Twenty-four examinations on 18 cases could thus 



