CHAPTER XII. 



VINCENT'S ANGINA. 



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

 membranous 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 remains 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 pseudomembrane is 

 sometimes quite distinct, the disease is apt to be mistaken for 

 diphtheria, and may be differentiated from it only by a bacteri- 

 ologic examination. When such an examination is made two 

 apparently different micro-organisms may be found. The 

 first is the Bacillus fusiformis; the second, Spirochaeta vin- 

 centi. 



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 Babes f also described a fusiform bacillus which 

 seems to be somewhat different, that occurred in a ne- 

 crotic exudation from a pseudomembranous 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 Matz- 

 enauer observed similar organisms in noma. Fusiform 

 bacilli are, therefore, not infrequently associated with ne- 

 crotic processes of various kinds. Similar but not identical 

 bacilli were found by Babes in the gums of scorbutic patients. 



* "Micro-organisms of the Human Mouth." 

 t "Les Bacteries," 1884. 

 478 



