VINCENT'S ANGINA 353 



site of injection in from twelve to twenty-four hours, and usually 

 a distinct reaction in the course of twenty-four to twenty-eight 

 hours. There is an indurated and reddened area of from 

 10 to 25 mm. in diameter. This reaches its height on the third 

 or fourth day. 1 



(B) In milk. See section on " Milk." 



Vincent's Angina 



An infective malady characterised by sore throat, fetor, 

 dysphagia, and ulceration, and membrane simulating diphtheria. 

 The diphtheria bacillus, however, is not present, and the affection 

 is apparently caused by an association of a bacillus and a spiro- 

 chaete. The bacillus (B. fusiformis) measures 6-8 /i to 10-12 p 

 in length, has pointed ends and is usually somewhat bent, not 

 straight, often appears feebly motile, and does not stain by Gram. 

 It can be cultivated anaerobically on the ordinary media to which 

 human blood-serum, ascitic or hydrocele fluid has been added. 

 In culture it develops filamentous forms but never spirochaetes. 

 The spirochaetes may be cultivated anaerobically in serum agar ; 

 they belong apparently to three varieties or species of Spironema, 

 which occur together in varying proportion. 2 They also are 

 Gram -negative. Smears may be stained with methylene blue 

 or dilute carbol-fuchsin, and the appearance of the associated 

 organisms is so characteristic that a diagnosis is easily effected 

 (Plate VII, &). 



Ulcero -membranous inflammatory affections caused by the 

 Vincent's organisms are not confined to the pharynx and tonsils, 

 but may be widely distributed on the mucous membrane of the 

 mouth and gums. They sometimes cause a diffuse ulcero-mem- 

 branous gingivitis, sometimes a more restricted infection of the 

 gums at the junction with the necks of the teeth fuso-spirillary 

 peridental or marginal gingivitis. These lesions are fairly common 

 and may be confused with pyorrhroa alveolaris. They have been 

 fully described by Taylor and McKinstry. 3 



1 See Leete, Lancet, 1920, vol. i, p. 192. 



2 See Semple, Price-Jones and Digby, Journ. Roy. Army Med. Corps, 

 xxxiii, 1919, pp. 217, 281. (Bibliog.) 



3 Roy. Soc. Med., Odontological Sect., Nov. 27, 1916. 



M.B. 23 



