596 Microscopic Organisms in Blood of Man and Animals. [part hi. 



recun"ent fever and in Ziemssen's " Handbuch " of Medicine ; Spirillum by Erichsen, 

 Litten, Birch-Hirschfeld, etc. ; Spirillum tenue by Naunyn ; and Spirochcete Ohermeieri 

 by Ck)hn (Fig. 51). 



The last-named observer, and the only one with an extended botanical experience, 

 gave it a specific distinction solely on physiological grounds, as, after careful examination, 

 he was unable to detect any difference, either of size or in character of movements, 

 between the spirillum of recurrent fever-blood and Spirillum (^Spirochcete) plicatile, which 

 had been found by Ehrenberg in water many years ago.* Cohn himself had subsequently 

 found it in water, and also in the mouth — in the mucous surrounding the teeth.t A 

 figure of this spirillum by Cohn is reproduced for convenience of comparison | (Fig. 52). 



It will be recollected that the late Dr. Obermeier himself had recognised the 

 spirillum in the mucous from the mouth of recurrent fever patients, possibly having 

 overlooked the circumstance that its presence in this fluid was not an 'abnormality. 

 Manassein,§ who, at St. Petersburg, has had favourable opportunities for observation, 

 expresses himself most strongly against the supposition that this microphyte is anything 

 more than an epi-phenomenon in recurrent fever. Not only was it absent from the blood 

 in certain of the cases of fever examined by himself and others, but spirilla precisely 

 similar to those found in other cases were, during a period of some months, constantly 

 present in the secretion which flowed on pressure from an abscess which opened into the 

 mouth of a fever-free patient. Billroth also states that similar spirilla were found in 

 connection with caries of bone. 



Heydenreich, who probably has investigated this matter as carefully as any observer, 

 and written the fullest account of it which has come under my notice, notwithstanding 

 his manifest desire to claim for the spirillum a causative relation to the disease, is, 

 nevertheless, compelled to own that sufficient reason has not been shown to warrant 

 its being described as specifically different from the spirillum of water and the ordinary 

 spirillum of the mouth. |1 



In May 1877 I had an opportunity of observing cases of fever in Bombay in which 

 " Dr. Vandyke jCarter had demonstrated the existence of spirillar organisms in the blood. 

 Dr. Carter has recently published an interesting account of his observations.^ These, 

 as far as the abstract of the paper submitted to the Pathological Society shows, coincide 

 closely with like observations in Europe. During my stay in Bombay I had an opportunity 

 of examining twenty-five cases of the disease, and observed the spirillum in five of these 



* Cohn's BeUrage ; Band I, Heft 3, 1875, p. 197. 



t Ditto, Band I, Heft 2, 1872, p. 180. 



% Ehrenberg suggested that the term Spirillum should be restricted to such of the Schizomycetes as 

 manifested spiral movements without flexibility, and for those of the group which were distinctly flexible 

 he proposed the term Spirochcete. As, however, 'the distinction is merely a matter of degree, spirilla also 

 manifesting a greater or less amount of flexibility, I have adhered to Dujardin's classification. Fomental {Etude 

 sur les Microzoalres, 1874) adopts the older and simpler term for a like reason. 



§ St. Peterslnirg. medicin. WocJienschrift. No. 18, 1876. 



II Op. cit., page 31. 



^ The Lancet, June 1878. 



