758 INFECTION AND IMMUNITY. 



emulsions from the nasopharyngeal mucous mem- 

 brane. The emulsions of central nervous tissues 

 give the most constant results, while the emul- 

 sions of other organs such as liver, spleen and 

 bone marrow have failed to give results. It is 

 possible that infection takes place in a manner 

 similar to the process in epidemic meningitis. 

 That is by dissemination of droplets and particles 

 from the nasopharvngeal membrane. 



In a reinoculation of ten monkeys which had 

 recovered from poliomyelitis, Flexner and Lewis 

 observed no instances of second attacks. In nor- 

 mal monkeys 72 per cent, of those inoculated be- 

 came infected and showed paralysis. Those which 

 did not become paralyzed were suspected of mild 

 attacks. It is possible that vaccination may be 

 successful. 



XV. NOMA. 



ISToma, or gangrenous stomatitis, is a somewhat 

 rare disease of children whose resistance is low- 

 ered by the acute infectious diseases. Among these 

 it is found most frequently associated with meas- 

 les. Next to measles, it is oftenest found in 

 typhoid, intermittent fever mercurialism, scarlet 

 fever, pertussis, enteritis, variola and many other 

 diseases. 



Fusiform Perthes, Seiffert, Matzenaur and others found 

 spirilla, associated with noma, fusiform bacilli and spirilla. 

 These observations have since been confirmed by 

 many others. The organisms are found in the 

 necrotic tissues and especially at the line of ad- 

 vancing necrosis. Ellerman, in 1904, cultivated 

 fusiform bacilli from a case of noma. Weaver 

 and Tunnicliff obtained pure cultures of fusiform 



