BACTERIA IN INFECTIOUS DISEASES. 615 



this becomes chronic a similar transfer of infectious material gives 

 rise to the chronic inflammatory process known as trachoma. Hoor 

 (1895) also ascribes trachoma to infection by gonococci, and believes 

 that in their etiology papillary trachoma (blennorrhcea chronica) and 

 granular trachoma (trachoma verum) are identical. 



TYPHOID FEVER. 



The etiological relation of Bacillus typhi abdominalis (No. 46) to 

 typhoid fever is now generally admitted by pathologists and bacteri- 

 ologists. 



TYPHUS FEVER. 



The etiology of typhus fever has not been determined in a definite man- 

 ner. Hlava (1888) has described a " streptobacillus " which he supposes to 

 be concerned in the etiology of this extremely contagious disease ; but it lias 

 been shown by other investigators that this bacillus is not constantly present, 

 and there is no satisfactory evidence that it is the specific infectious agent. 



Thoinet and Calmette (1892) examined the blood in seven cases and were 

 unable to find the streptobacillus of Hlava ; their cultures from the spleen of 

 living patients and from the spleen and blood from the heart of recent cadav- 

 ers gave a negative result. They found, however, in blood examined under 

 the microscope abnormal elements, in the form of motile granules and fila- 

 ments, which were sometimes adherent to the red blood corpuscles. Lewa- 

 schoff in 1892 claimed to have found in the blood of typhus patients motile 

 micrococci having long spiral flagella. In a subsequent epidemic Lewa- 

 schoff (1894) claims to have found the same microorganism in one hundred 

 and eighteen cases examined, and also to have obtained in cultures from blood 

 taken from the spleen or from the finger the same microorganism, sometimes 

 solitary and provided with flagella, and sometimes in chains. Weinshal 



(1892) in ten cases examined by the method recommended by Lewaschoff was 

 unable to find the microorganism described by him or any other. Hlava 



(1893) in his more recent researches has not obtained his streptobacillus in 

 cultures made soon after death (ten cases) ; but he obtained various micro- 

 organisms in his cultures from the spleen, lungs, etc., which he concludes 

 are not directly concerned in the etiology of the disease streptococci, staphy- 

 lococci, pseudo-diphtheria bacilli, and a proteus ("Vibrio proteus ruber"). 

 He also observed in the blood and spleen bodies resembling the spores of 

 yeast fungi. 



Dubieff and Bruhl (1893) in nine cases examined (six post-mortem) found 

 in small numbers in the blood and spleen a diplococcus, called by them Dip- 

 lococcus exaiithematicus. This is said to have been difficult to cultivate and 

 to have been present in enormous numbers in mucus from the nose and 

 throat and from pneumonic foci in the lungs. 



Calmette (1893), in a detailed account of the microorganism previously 

 described by himself and Thoinet, reports that this is especially abundant in 

 splenic pulp obtained by an aspirating syringe during life. The bodies found 

 are actively motile, and from 2 to 3 /^ in diameter, having sometimes a fili- 

 form appendage from 4 to 5 \i in length. Long spiral filaments are also occa- 

 sionally seen ; these are from 20 to 30 \L long and 1 to 2 fj. thick ; they are ac- 

 tively motile. Cultures from blood were obtained in media containing sugar 

 or acidified with lactic or tartaric acid. This microorganism is believed by 

 Calmette to be a microscopic fungus, belonging to the ascomycetes, or to the 

 genus Ustilago. Curtis and Combemale (1893) in cultures from blood drawn 

 from the finger, in twelve cases, had invariably a negative result ; in three 



