494 CHAMBERLAIN. 



resembled Bacillus fiisifornils. Eecently, on re-examining smears from 

 this case, we found a few perfectly typical fusiform bacilli ; they had the ■ 

 characteristic barred appearance when stained. 



In searching fresh sputa for yeast the Board recently found specimens 

 from 2 patients which showed large numbers of actively motile spiro- 

 chsetse. Both of these patients were Filipinos suffering from typhoid 

 fever. Specimens of sputum from 33 other patients having cough with 

 expectoration were examined and none contained spirochgetas except one 

 which had an extremely few, thick, spiral organisms such as might easily 

 have entered the sputum from around the necks of the teeth where such 

 organisms are common. Of the 32 patients, 27 were Americans and 5 

 natives. 



The histories of the 2 eases, the sputa of which contained spiro- 

 chsetas, are given through the courtesy of Captains H. S. Hansell and C. 

 L. Poster, Medical Corps, who had charge of the patients. 



Case I. — Udasco, Private, 23rd Company Philippine Scouts, age 2.3. Service 

 two years and eiglit months. Tribe, Iloeano. Admitted to hospital November 3, 

 1910. Family and previous history imknown. Bad cough for three weeks 

 previous to admission, and slight expectoration. Noted no blood. Headache and 

 fever but no chills. On admission to hospital patient appeared very ill. Pulse 

 regular and normal. A few vesicles on back and chest. Rales heard over both 

 lungs. Abdomen distended and typanitic. Liver and spleen not palpable. Sub- 

 sequently spleen was found palpable. Patient ran an irregular febrile course 

 for twenty days, followed by a period of ten days of continued high fever 

 associated with abdominal distention and constipation { relapse ? ) , since which 

 time (twenty-six days) there have been several unaccountable elevations of 

 temperature. The Widal reaction was negative November 4, 5, and 6, partial on 

 November 7, and positive on November 8. Blood was negative for Bacillus 

 typhosus on November ,7. Stools and urine were only examined during con- 

 valescence when they were negative for typhoid bacilli. The condition of the 

 patient gradually improved after the relapse, and the cough disappeared. 



Eleven specimens of sputum obtained at intervals were negative for tubercle 

 bacilli. Stools negative for amoebae and for ova except Tricocephalus dispar. No 

 malarial parasites were found. There was a slight leucocytosis ranging from 

 8,000 to 15,000. Differential counts showed nothing of importance, averaging; 

 polymorphonuclears 61 per cent, small lymphocytes 36 per cent, large mononuclears 

 2 per cent, and eosinophiles 1 jier cent. Urine during febrile period showed a 

 trace of albumin and a few granular casts. Diazo reaction negative. Subsequently 

 urine became normal. 



On November 30 and on several succeeding days the sputum contained great 

 numbers of spirochoetie. Prior to that no effort had been made to find them as 

 will be explained below when referring to staining methods. The sputum was 

 thin and watery containing a large number of small grayish flakes which 

 consisted of masses of cocci, many kinds of bacilli, and a few epithelial cells and 

 leucocytes. There was no blood and no bad odor. 



After a lapse of over four weeks (December 31, 1910) the sputum, obtained 

 on forced cough, was of the same flakey character as described above and contained 

 numerous spirochajtae. 



