520 SYPHILIS 



lesions also. It has been found to be present in the peripheral 

 parts of gummata, especially at an early stage of their forma- 

 tion; and the observations of Schmorl, Benda, J. H. Wright, 

 and others show that it is often to be found in syphilitic 

 disease of arteries, sometimes occurring in considerable numbers 

 in the thickened patches in the aorta. That the spirochaete may 

 persist in the body for a very long time after infection, has been 

 abundantly shown by different observers; in one case, for 

 example, its presence was demonstrated sixteen years after the 

 primary lesion. It can readily be demonstrated in sections of 

 syphilitic lesions by the method described on page 113. Quite 

 recently Noguchi and Moore have announced the discovery of 

 the spirochaete in the brain in general paralysis of the insane 



in a certain proportion of cases. 

 The organism was seen in all the 

 layers of the cerebral cortex, with 

 * the exception of the outermost, 

 Ijfik and the cases in which it was 



H S8j found had run a relatively rapid 



H| course. This manifestly is an 

 observation of the highest im- 

 - ' ! portance. 



In preparations from the organs 

 in congenital syphilis large num- 

 bers of spirochaetes, chiefly extra- 



FIG. 160. Spirochsete refringens vascular in position, can be seen, 

 in film preparation from a case and many may occur in the 

 ofbalanitis. x 1000. interior of the more highly 



specialised cells, for example, liver- 

 cells ; in many cases examination has been made within 

 so short a period after the death of the child as to exclude 

 the possibility of contamination from without. It also abounds 

 sometimes on mucous surfaces, e.g., of the bladder and intes- 

 tine in cases of congenital syphilis. The enormous numbers 

 of the organism which may be present in a well-preserved 

 condition in macerated foetuses render it probable that the 

 organism may multiply in the dead tissues under anaerobic 

 conditions. Shortly after the discovery of the organism, Metch- 

 nikoff was able to detect it in the lesions produced in monkeys 

 by inoculation with material derived from syphilitic sores, and 

 his observations have since been confirmed. Another question 

 of considerable importance is, as to whether this organism has 

 been found in other conditions. Observations show that in 

 various conditions, such as ulcerated carcinomata, balanitis, etc., 



