NOMA. 759 



bacilli from noma in 1905. The organism is an 

 obligative anaerobe requiring a temperature of 

 about 37 C. for growth. The presence of blood 

 serum or ascites fluid is necessary for obtaining 

 the best growth, but cultures can be obtained on 

 glycerin agar. All cultures have a foul odor. 



On ascites agar the bacilli occur as delicate 

 pointed Gram-negative rods. In ascites broth the 

 organisms are more slender, not so pointed, and 

 tend to form chains. On solid media wavy fila- 

 ments are found. In old cultures forms similar 

 to the spirilla found in the tissues were found. 

 Tunnicliff isolated from the gums of healthy sub- 

 jects, fusiform bacilli which were apparently iden- 

 tical in cultural characteristics and morphology 

 with those found in noma. In pure cultures 

 grown several days spirilla were found rather con- 

 stantly and it would seem as if the spirilla were 

 simply a stage in the development of the fusiform 

 bacilli. 



The number of cases in which the bacilli and 

 spirilla have been found associated with noma 

 makes it strongly probable that they are the cause 

 of the disease. 



Fusiform bacilli and spirilla similar to those 

 isolated from noma have been found in ulcero- 

 membranous angina and stomatitis, in hospital 

 gangrene and in fetid infections in various parts 

 of the body. 



