PELLAGRA 563 



etc. In thirty-seven cases of mastoid disease Blake found the 

 following organisms, and remarks that as a rule the same were 

 found in the middle ear : 



Streptococcus ....... 12 



Staphylococcus ....... 5 



Diplococcus (? pneumonice) ..... 6 



Streptococcus and diplococcus .... 5 



Streptococcus and Bacillus fetidus ( ? colon bacillus) 3 



Streptococcus and Bacillus pyocyaneus ... 1 



Streptococcus and diplococcus .... 1 



Streptococcus, micrococcus, and diplococcus . . 2 



In two of the cases no organisms could be isolated. 



OZJENA (ATROPHIC RHINITIS). Lowenberg described in this 

 disease encapsuled bacilli somewhat resembling the pneumo-bacillus 

 morphologically. Some Italian observers found bacilli apparently 

 identical with the diphtheria bacillus. Abel * described a bacillus 

 somewhat resembling the pneumo-bacillus. It is this organism 

 which produces the atrophy of the mucous membrane, but the 

 fetor is due to the decomposition of the secretions produced by 

 other organisms. 



Perez 2 isolated an organism in ozsena (Cocco-bacillus fetidus 

 ozcence) which has the following characters : it is a short bacillus 

 with rounded ends, non-motile, does not stain by Gram's method, 

 does not liquefy gelatin, does not ferment lactose nor curdle milk, 

 but forms indole and ferments urea. Its cultures are foul-smelling, 

 and it is pathogenic for guinea-pigs, mice, rabbits, and pigeons. 



PELLAGRA. Many hypotheses have been propounded to account 

 for the causation of this disease, in which no micro-organism has 

 been detected with certainty. It formerly was supposed to be due 

 to the consumption of maize, which contains toxic substances. 

 Lombroso suggested that spoilt maize is the cause, toxic substances 

 being produced by Penicillium glaucum. Of parasitic theories, 

 Ceni and others suggest infection with Aspergillus fumigatus or 

 A. flavescens. Tizzoni attributes it to the pleomorphic, Strepto- 

 bacillus pellagrce (which may be a pleomorphic form of an 

 actinomycotic organism). Sambon on epidemiological data 

 believes that a protozoan parasite is the agent and is trans- 

 mitted by small biting flies of the genus Simulium. The sun's rays 

 have also been supposed to cause the affection. 3 



1 Zeitschr. f. Hyg., xxi, p. 89. 



2 Ann. de Vlnst. Pasteur, xiii, 1899, p. 937, and xv, 1901, p. 409. 



3 See First Progress Rep. of the Thompson-McFadden Pellagra 

 Commission. 



