THE SPIROCILETE IN RELATION TO SYPHILIS 721 



(Veillon and Girard), but in the rash the organisms are very few in number and 

 difficult to demonstrate. 



The blood is also infective at times and in a transitory manner during the secondary 

 period, and on inoculation into monkeys will produce syphilis in about 50 per cent, 

 of the animals inoculated. The number of treponemata in the blood is, however, 

 small, and this fact explains the failure of many observers to detect their presence. 

 Nevertheless, by adopting improved methods of observation, the organism has been 

 found in the peripheral circulation. The treponema may also be found in the fluid 

 obtained by blistering a non-ulcerated lesion of the skin (Levaditi and Petresco). 



The organism can almost never be found in the internal organs : though in one 

 case Schaudinn and Hoffmann were able to demonstrate it in a stained specimen 

 of material obtained by puncture of the spleen. During the secondary period the 

 secretion of the testes is sometimes infective but the treponema has never been 

 demonstrated in it. 



3. In the lesions of tertiary syphilis the treponema is present but in small numbers 

 only ; these lesions are, however, infective. Monkeys, for instance, have been 

 infected with fragments of gummata and with the blood of a patient in the tertiary 

 stage (Hoffmann). Many observers have failed to find the treponema by staining 

 material from tertiary lesions ; the organism has nevertheless been found in the 

 papules and in gummata. Reuter demonstrated the organism in the walls of the 

 aorta of a person affected with syphilitic aortitis. 



4. The treponema is found in largest numbers and in every organ of the body in 

 congenital syphilis and in this form of the disease the blood is much more frequently 

 infected than is the case with syphilis in the adult. Thus it has been demonstrated 

 in the skin in pemphigus, in the bones in osteo-chondritis, and in the inguinal 

 lymphatic glands. In the alimentary system it has been found in the mucous mem- 

 brane of the cheeks and pharynx, in the tonsils, in the walls of the stomach and in 

 the liver and gall-bladder. In the geni to -urinary tract its presence has been noted 

 in the bladder and in the ovary and it may even penetrate into the Graafian follicles 

 (Hoffmann, Levaditi and Sauvage). It occurs in the ductless glands, spleen, supra- 

 renal glands and thymus. It is present also in the lungs. In the nervous system 

 it has been described in inflammatory foci in the meninges, in the brain and in 

 the peripheral nerves. 



Spirochsetes are found in the placenta only when the infant has obvious manifesta- 

 tions of a syphilitic infection. 



5. The treponema is found in the primary and secondary lesions of experimentally 

 infected monkeys (Roux and Metchnikoff, Neisser, Hoffmann and others). Although 

 the internal organs (spleen, bone marrow, lymphatic glands) are infective (Neisser) 

 the treponema has not hitherto been demonstrated in them. 



[Now that Noguchi has succeeded in growing the Treponema palhdum in 

 pure culture (p. 737) and has been able to produce typical syphilitic 

 lesions in rabbits by the inoculation of his pure cultures there is evidence 

 that at any rate the lesions produced in the rabbit by the inoculation of 

 syphilitic material are due to the treponema and not to any adventitious 

 organisms which may have been inoculated with it.] 



SECTION I. EXPERIMENTAL INOCULATION. 



The experimental study of syphilis was for a long time very barren of 

 results. Inoculation of man, despite its seriousness, was occasionally per- 

 formed and the fundamental basis of the aetiology of the disease established. 

 On account of the difficulties and dangers attending the inoculation of 

 syphilitic material into man, experiments were undertaken with the object 

 of infecting the lower animals. Experiments on the ordinary laboratory 

 animals repeatedly failed and resort was had to monkeys, but here again, 

 inoculation of the lower monkeys gave only inconstant and inconclusive 

 results. 



Experiments were then carried out on the anthropoid apes by Roux and 



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