528 



TREPONEMATA AND SPI ROCHET A 



not necessarily in intimate association with bloodvessels; in syphilis 

 the organisms are found in considerable numbers around thickened 

 arteries. Treponema pertenue is found constantly in the primary 

 lesion and in unbroken papules of the generalized eruption charac- 

 teristic of the secondary stage of yaws. In broken down lesions many 

 bacteria, including Treponemata indistinguishable from Treponema 

 refringens, complicate the picture. They are frequently not found in 

 the tertiary stage. At autopsy the spleen, lymph glands and bone 

 marrow contain many Treponemata as a rule; the cerebrospinal 

 fluid is free from them ante- or postmortem. 



The disease is transmissible by direct contact, and it is probable 

 that the virus may be transmitted by biting insects as well. 



FIG. 77. Treponema balanitidis. (Corbus.) 



Treponema Phagedenis. Synonym. Spirocheta balanitidis. 



Schaudinn and Hoffmann, 1 Miihlens, 2 Hoffmann and Prowazek 3 

 and others have described spiral organisms resembling Treponema 

 refringens in size, shape and motility in genital and perigenital ulcer a- 

 tions and in phagedenic ulcers. Similar organisms have been observed 

 in noma. Corbus and Harris 4 and Corbus 5 have described a spiral 

 organism resembling Vincent's spiral in several cases of erosive and 

 gangrenous balanitis, and Brault 6 has observed a similar spiral asso- 

 ciated with a fusiform bacillus in two cases of noma. The identity 

 of the various organisms is as yet undetermined, and their etiological 



1 Arb. a. d. kais. Gesamte, 1905, xxii, Heft 2. 



2 Centralbl. f. Bakt., Orig., 1907, xlii, 277. 



3 Ibid., 1906, xli, 741, 817. 



4 Jour. Am. Med. Assn., 1909, lii, 1474. 



6 Ibid., 1913, Ix, 1769. 6 Bull. Derm, et Syph., 1908, 2. 



