728 Syphilis 



malaise, loss of appetite, and diarrhea. Noguchi found that the 

 reaction is specific, that it is most striking and most constantly 

 present in tertiary, latent tertiary, and congenital syphilis. It, 

 therefore, forms a valuable adjunct to diagnosis, seeing that it is 

 most evident in precisely those cases in which the Wassermann 

 reaction is most apt to fail. A few early cases energetically treated 

 with mercury and salvarsan give marked reactions. A few old 

 cases fail to give it. 



SPIROCH^TA REFRINGENS (SCHAUDINN AND HOFFMANN) 



This spiral organism, though given the name by which it is now known by 

 Schaudinn and Hoffmann, was probably first described by Donne under the name 

 Vibrio lineola. It is probably a frequent organism of the skin and mucous mem- 

 branes, and occurs in greatest numbers in lesions of the genitalia because of the 

 smegma upon which it customarily lives. It is present in most primary lesions 

 of syphilis, but is no less frequently found in non-syphilitic lesions, such as bal- 

 anitis, venereal warts, and genital carcinoma. It is also found in the mouth and 

 on the tonsils. According to Hoffmann and Prowazek* it is not entirely harmless, 

 but has a pathogenic action, and some of the complicating lesions of syphilis as 

 well as some of the destructive diseases of the genitals may be intensified by it. 

 They found it pathogenic for apes. 



Morphologically, it is much broader than Treponema pallidum, its spiral waves 

 are much coarser and less regular. It is easy to stain by all methods and is hence 

 easily found. It has been cultivated by Noguchi. f 



* "Centralbl. f. Bakt.," etc., 1906, XLI. 



t "Journal of Experimental Medicine," May i, 1912, xv. 



