CHAPTER XIII 

 VINCENT'S ANGINA 



VINCENT'S angina is an acute, specific, infectious, pseudo-membran- 

 ous form of pharyngitis or tonsillitis characterized by the formation of 

 a soft yellowish-green exudate upon the mucous membranes, which, 

 when removed, leaves a bleeding surface which becomes an ulcer. 

 Sometimes these ulcers are superficial, sometimes they are deep, 

 necrotic, and fetid. There is considerable pain on swallowing, some 

 fever, and some prostration. The patient not infrequently keeps up 

 and about, though feeling very badly. The ulcerations sometimes 

 persist for several months. As there is considerable swelling of the 

 glands of the neck and as the pseudo-membrane is sometimes quite 

 distinct, the disease is apt to be mistaken for diphtheria, and may be 

 differentiated from it only by a bacteriologic examination. When 

 such an examination is made two apparently different micro-or- 

 ganisms may be found. The first is the Bacillus fusiformis; the sec- 

 ond, Spirochaeta vincenti. 



BACILLUS FUSIFORMIS (BABES (?)) 



In 1882 Miller* described a fusiform bacillus that occurred in 

 small numbers between the gums and the teeth and in cavities in 

 carious teeth in the human mouth. In 1884 Cornil and Babesf also 

 described a fusiform bacillus which seems to be somewhat different, 

 that occurred in a necrotic exudation from a pseudo-membranous 

 diphtheritic pharyngitis in school children. Lammershirt, Vincent, 

 Nicolle, Plaut, and others observed similar cases. Later Lichtowitz 

 and Sabrazes observed great numbers of fusiform bacilli in the pus 

 of a maxillary empyema. Elders and Matzenauer observed similar 

 organisms in noma. Fusiform bacilli are, therefore, not infrequently 

 associated with necrotic processes of various kinds. Similar but 

 not identical bacilli were found by Babes in the gums of scorbutic 

 patients. 



SPIROCHAETA VINCENTI (PLAUT- VINCENT) 



PlautJ and Vincent observed that in the ulcerative and necrotic 

 pharyngitis described, together with the fusiform bacilli, there were 

 varying numbers of spiral organisms. These were 'difficult to stain, 



* "Micro-organisms of the Human Mouth." Philadelphia, 1890. 



t "Lcs Bacteries," 1884. 



j " Deutsche med. Wochenschrift," 1894, XLEX. 



"Ann. de 1'Inst. Pasteur," 1896, 488. 



28 433 





