154 CLINICAL BACTERIOLOGY AND ILEMATOLOGY 



No conclusions as to the origin of the angina or as to its 

 prognosis can be given from the discovery of the causal 

 organism. The presence of a streptococcus renders it pos- 

 sible that the disease is scarlet fever, but certainly d <:s not 

 prove it. Nor does the examination give much help as to 

 treatment. If the disease is due to a streptococcus and the 

 symptoms are severe, antistreptococcic serum or vaccine may 

 be given, the local treatment being continued as usual, and the 

 other infections may all be treated with their appropriate 

 vaccines. 



VINCENT'S ANGINA is a very interesting form of sore throat 

 recently described by Professor Vincent, of Paris, and is 

 especially important since (i) it closely resembles diphtheria, 

 and the two may be readily confounded, and it also may easily 

 be confused with a syphilitic lesion; and (2) it is readily cured 

 by appropriate treatment friction twice daily with a tampon 

 soaked in tincture of iodine, or spraying with eusol, etc. It is 

 not very uncommon in this country, though it was long 

 overlooked. 



Vincent describes two forms : 



1. An ulcer o-menibranous variety, which commences with 

 fever and general malaise, and with redness of a tonsil or of 

 a pillar of the fauces. In a day or two* a grey or yellowish 

 false membrane appears on the injected area; it is soft and but 

 slig'htly adherent, and when removed the mucous membrane 

 is found to be ulcerated. As the disease proceeds the mem- 

 brane increases in thickness, and a deep ulcer is formed. The 

 breath is foetid and the tong'ue furred, salivation occurs, and 

 deglutition is painful. The submaxillary glands may be 

 enlarged. In most cases the patient recovers in a week or 

 fortnight, but the affection may become chronic and last a 

 month or more. 



More severe forms occur in which the soft palate, uvula, 

 tongue, etc., are invaded, and ulceration also occurs. In some 

 cases there is a scarlatiniform rash, which might lead to the 

 diagnosis of scarlet fever. 



2. The diphtheroid form is rarer, occurring" in only 2 per 

 cent, of Vrncent's cases. The onset is accompanied by a little 

 fever, some difficulty in swallowing, and fcetor of the breath. 

 Locally, the mucous membrane is inflamed and injected, and 

 a whitish membrane is formed; it is thin at first, but becomes 



