

BACTERIOLOGICAL EXAMINATION OF MATERIAL 219 



siderable length in another place. As discussed there, these organisms 

 when they are present are usually located high up in the pharynx 

 near its roof, and successful search for carriers depends very largely 

 upon care of reaching the right spot with the swab. 



Of bacilli, the mouth contains a large variety at different times. 

 Few of these, however, are confusing from the bacteriologist's point 

 of view, except some of the diphtheroids. The pseudo-diphtheria 

 bacillus, or Bacillus Hoffmanni, may be present without having any 

 relationship to disease. It is described in another section. The other 

 larger and more irregular diphtheroids are not uncommon, and are 

 easily distinguished from true diphtheria bacilli by their appearance 

 and cultural characteristics. 



Chain- forming Gram-positive bacilli and large obviously sapro- 

 phytic varieties may be present in very dirty mouths, but offer no 

 bacteriological difficulties. 



Of the Gram-negative bacilli, Proteus, Lactis Aerogenes, and special 

 members of the Friedldnder group may be present. We have known 

 one man who habitually had a Friedlander culture in his mouth, with- 

 out ever suffering any harm from its presence. 



The fusiform bacillus described in another section in connection 

 with Vincent's angina, is almost always present between the gums and 

 the teeth in mouths that are dirty, with carious teeth or where there 

 is some inflammation of the gums themselves. It is an observation 

 that we make almost every year with our students, that, if a platinum 

 loop is passed between the base of the tooth and the gums, and smears 

 taken from a number of students, the bacteria usually associated with 

 Vincent's angina, spirochsetes and fusiform bacilli, can be seen in 

 one or another of the cases examined. 



Spirilla and spirochaetes are almost habitually present. The 

 Spirillum Milleri, named after Miller, who has made valuable studies 

 upon mouth bacteria, is a small true spirillum, easily cultivated, and 

 not easily confused with other morphologically similar organisms. 

 Miller cultivated three of four varieties of mouth spirilla. 



True treponema (Noguchi's classification), are almost always 

 present in locations like those described for the fusiform bacilli, and 

 even on the mucous membranes, especially when small spots of necrosis 

 or inflammation occur. Most frequently discussed among these are 

 the large spirochaete, associated with Vincent's angina, the Spironema 

 Vincenti. There are, likewise, present very frequently the treponema 

 macrodentium and microdentium, classified thus by Noguchi. These 



