Spirochaeta Refringens 799 



pain or itching, which disappeared without induration within 

 forty-eight hours. In the syphilitics at the end of forty-eight 

 hours there was an induration in the form of a papule 5 to 

 10 mm. in diameter, surrounded by a zone of redness and 

 telangiectasis. This slowly increased for three or four days 

 and became dark bluish red. It usually disappeared in about 

 a week. Sometimes the papule underwent vesiculation and 

 sometimes pustulation. It always healed kindly without in- 

 duration. In certain cases described as torpid, the erythema 

 cleared away and a negative result was supposed to have re- 

 sulted, when suddenly the spots lighted up again and pro- 

 gressed to vesiculation or pustulation. In 3 cases there were 

 constitutional symptoms malaise, loss of appetite, and diar- 

 rhea. 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 geni- 

 talia 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 balanitis, 

 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 palli- 

 dum, 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, xu. 



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



