﻿604 
  ANNUAL 
  EEPORT 
  SMITHSONIAN 
  INSTITUTION, 
  19 
  2 
  9 
  

  

  In 
  1918 
  Noguchi 
  became 
  a 
  member 
  of 
  the 
  commission 
  sent 
  by 
  the 
  

   Rockefeller 
  Foundation 
  to 
  Guayaquil, 
  Ecuador, 
  to 
  investigate 
  yellow 
  

   fever. 
  This 
  was 
  the 
  first 
  of 
  four 
  expeditions 
  made 
  by 
  him 
  to 
  South 
  

   America 
  between 
  1918 
  and 
  1924. 
  On 
  each 
  expedition 
  he 
  isolated 
  

   in 
  culture 
  a 
  spiral 
  organism 
  from 
  cases 
  diagnosed 
  as 
  yellow 
  fevei 
  

   which 
  he 
  subsequently 
  named 
  Leptospira 
  icteroides. 
  He 
  came 
  to 
  

   regard 
  this 
  spiral, 
  which 
  he 
  recognized 
  as 
  biologically 
  related 
  to 
  the 
  

   spiral 
  organism 
  of 
  infectious 
  or 
  hemorrhagic 
  jaundice, 
  as 
  the 
  parasitic 
  

   incitant 
  of 
  yellow 
  fever. 
  In 
  all 
  his 
  studies 
  he 
  secured 
  the 
  spiral 
  only 
  

   in 
  a 
  part 
  of 
  the 
  cases 
  examined 
  — 
  6 
  of 
  27 
  in 
  Guayaquil 
  — 
  but 
  he 
  

   detected 
  evidences 
  in 
  the 
  blood 
  of 
  other 
  cases 
  of 
  the 
  presence 
  of 
  

   the 
  spiral 
  at 
  some 
  time. 
  This 
  spiral 
  was 
  found 
  afterwards 
  by 
  other 
  

   bacteriologists 
  by 
  the 
  employment 
  of 
  Noguchi's 
  technique. 
  How- 
  

   ever, 
  there 
  were 
  many 
  failures 
  also 
  to 
  confirm 
  his 
  findings. 
  At 
  

   the 
  present 
  moment, 
  Noguchi's 
  work 
  on 
  yellow 
  fever 
  in 
  South 
  America 
  

   has 
  come 
  into 
  question, 
  so 
  that 
  it 
  is 
  desirable 
  to 
  perceive 
  clearly 
  

   just 
  what 
  the 
  question 
  is. 
  There 
  is 
  no 
  doubt 
  that 
  Noguchi 
  and 
  

   others 
  cultivated 
  Leptospira 
  icteroides 
  from 
  the 
  cases 
  diagnosed 
  by 
  

   clinical 
  experts 
  as 
  yellow 
  fever, 
  and 
  with 
  the 
  cultures 
  reproduced 
  in 
  

   animals 
  symptoms 
  and 
  pathological 
  changes 
  resembling 
  those 
  of 
  

   yellow 
  fever 
  in 
  man. 
  Now 
  that 
  the 
  extensive 
  investigations 
  of 
  

   African 
  yellow 
  fever 
  by 
  Adrian 
  Stokes 
  and 
  others 
  have 
  failed 
  to 
  

   reveal 
  the 
  leptospira 
  and 
  have 
  yielded 
  a 
  filter-passing 
  virus, 
  believed 
  

   to 
  be 
  the 
  incitant 
  of 
  the 
  disease, 
  and 
  the 
  reinvestigation 
  of 
  South 
  

   American 
  yellow 
  fever 
  is 
  offering 
  results 
  tending 
  to 
  confirm 
  the 
  

   African 
  findings, 
  there 
  is 
  inclination 
  to 
  discredit 
  Noguchi's 
  earlier 
  

   studies. 
  There 
  is 
  really 
  no 
  conflict 
  between 
  the 
  two 
  classes 
  of 
  find- 
  

   ings 
  — 
  the 
  only 
  conflict 
  possible 
  arises 
  from 
  the 
  interpretation 
  to 
  

   be 
  placed 
  upon 
  each. 
  Recent 
  experience, 
  gained 
  with 
  fuU 
  knowl- 
  

   edge 
  of 
  the 
  existence 
  of 
  the 
  filterable 
  virus, 
  has 
  reestablished 
  the 
  

   occurrence 
  of 
  leptospira 
  in 
  the 
  blood 
  of 
  yellow-fever 
  patients. 
  The 
  

   future 
  alone 
  can 
  determine 
  whether 
  cases 
  of 
  another 
  infectious 
  

   disease, 
  due 
  to 
  leptospira, 
  have 
  been 
  and 
  still 
  are 
  confused 
  clini- 
  

   cally 
  with 
  yellow 
  fever, 
  or 
  whether 
  in 
  yellow 
  fever 
  a 
  second 
  patho- 
  

   genic 
  leptospiral 
  microorganism 
  sometimes 
  invades 
  the 
  blood. 
  Such 
  

   instances 
  of 
  secondary 
  or 
  concomitant 
  infection 
  are, 
  of 
  course, 
  known 
  

   to 
  arise 
  in 
  other 
  defined 
  or 
  specific 
  diseases. 
  

  

  In 
  1925 
  Dr. 
  T. 
  Battistini, 
  of 
  Lima, 
  came 
  to 
  study 
  with 
  Noguchi 
  

   under 
  a 
  Rockefeller 
  Foundation 
  fellowship. 
  He 
  brought 
  with 
  him 
  a 
  

   sample 
  of 
  blood 
  taken 
  from 
  a 
  case 
  of 
  Oroya 
  fever. 
  This 
  circumstance 
  

   enabled 
  Noguchi 
  to 
  turn 
  his 
  attention 
  to 
  the 
  rod-shaped 
  bodies 
  found 
  

   by 
  Doctor 
  Barton 
  in 
  1905 
  in 
  the 
  red 
  corpuscles 
  of 
  persons 
  suffering 
  

   from 
  the 
  disease. 
  These 
  bodies 
  had 
  not 
  been 
  secured 
  in 
  artificial 
  

   culture 
  and 
  were 
  looked 
  upon 
  not 
  as 
  bacteria 
  but 
  as 
  protozoa. 
  Nogu- 
  

   chi 
  threw 
  himself 
  into 
  this 
  problem 
  with 
  characteristic 
  energy, 
  and 
  the 
  

  

  