220 BIOLOGY AND TECHNIQUE 



organisms are best observed under the dark field, but can also be 

 stained in smear if strong gentian violet or carbol fuchsin are used. 

 It is important to note that morphologically the macrodentium is very 

 similar to the treponema pallidum, and in the dark field examination 

 of syphilitic lesions of the mouth and throat, this similarity must be 

 carefully taken into account. We have seen cases in which we were 

 unwilling to make a definite diagnosis on these findings alone. It 

 is our belief that whenever extensive necrosis of the tissues of the 

 mouth and pharynx occur in consequence of other infection or or injury, 

 the necrotic tissues are apt to be invaded by fusiform bacilli, and 

 spirochaetes, which in subsequent examination dominate the bac- 

 teriological picture. We believe, however, that in the large majority 

 of these cases, perhaps including the clinical picture spoken of as 

 Vincent's angina, the trepdnemata and fusiform bacilli are secondary 

 to the primary etiological factors, such as those mentioned. These 

 organisms are anaerobic. We believe that the early contention of 

 Tunnicliff that the spirochaetes and fusiform bacilli found in Yin- 

 cent 's Angina are different stages of the same organism, is not generally 

 accepted to-day. 



The normal mouth is also apt to contain occasional members of 

 the Leptotkrix and Streptothrix groups. One of these, the LeptotJirix 

 innominata of Miller, is supposed to be characteristic of the mouth 

 flora. It may appear as a large Gram-positive bacillus form which 

 is believed by some writers to be a true bacillus, rather than a lepto- 

 thrix, and is spoken of as the Bacillus Maximus Buccalis (Miller). 



Bacteria in the Nose and Accessory Sinuses. That the nasal mucosa 

 should be a favorable site for the deposit of numerous microorgan- 

 isms follows from the fact that air is constantly passing in and out 

 during respiration. The varieties of bacteria to be found in the 

 nose, therefore, may belong to any that happen to be present in 

 the inhaled air. 



The subject of the bacteriology of the nose deserves more atten- 

 tion than has been given to it during recent years, for infections 

 of the nasal sinuses and the conditions which lead to them, are being 

 recognized of the utmost importance upon general health. Earlier 

 investigators claimed that the passage of bacteria in the air to the 

 deeper respiratory organs is very largely arrested by a sort of 

 filtering action in the nose. Thomson and Hewlett 7 found that in 



''Thomson and Hewlett, Baumgarten's Jahresb., 12, 1896, 767. 



