496 CHAMBERLAIN. 



in symbiosis with spirochsetse in the so-called Vincent's angina. It is 

 interesting to note that in history, symptoms, and character of the 

 sputum these two cases were almost identical except that one contained 

 fusiform bacilli and the other did not. Whether the presence of a few 

 fusiform bacilli in one of these sputa, and in the sputum formerly 

 described by Phalen and Kilbourne, was due to a contamination of the 

 phlegm while it was passing through the mouth can not be determined. 

 It is certain that the bacilli were present in both sputa in much smaller 

 relative numbers than is usually the case in ulcers of the mouth and 

 fauces when the symbiotic bacilli and spirochsetae are encountered. 



In many of the cases described in the literature spirochgetosis appears 

 to be an independent disease. In considering the two histories recorded 

 above it must be remembered that both patients were very ill with typhoid 

 fever and, therefore, the presence of the organism's in the bronchial 

 secretion may have been due simply to a migration downward, in a 

 debilitated individual, of the spirochsetae which normally have a limited 

 habitat in the mouth. However, the persistence of the spirochsetae in 

 the sputum far into convalescence seems to be opposed to this view of 

 the matter. 



PREVALENCE OF SPIROOH^T^ AND FUSIFORM BACILLI IN LESIONS 

 OCCURRING IN NON-TROPICAL COUNTRIES. 



These associated organisms are probably much more common in oral 

 and faucial lesions than is generally thought to be the case and would 

 doubtless be very frequently met with if the practice of examining smears 

 from ulcers in those regions was more general. 



Rodella found the two organisms present in about one third of the 2,000 eases 

 of pseudo-membraneous anginas which he examined. (5) Beitzke demonstrated 

 the organisms in 5 out of 58 patients suspected of having diphtheria. Lublowitz 

 reports the presence of fusiform bacilli in 6 out of 38 ulcers of the mouth. 

 Arnold found the two organisms in 3 out of 5 eases of follicular tonsilitis. 



Rothwell(l4) under the title of "Bronchial Vincent's Angina" reports 4 cases, 

 which have come to his notice in Missouri, where the sputum was swarming with 

 fusiform bacilli and spirochsetfe. There was bloody expectoration and the 

 symptoms somewhat resembled asthma. Cases of foetid bronchitis and pneumonia 

 have been reported in which the sputum contained these 2 organisms, but as yet 

 the reports of pulmonary cases in temperate regions are so few that no reliable 

 estimate can be made as to the real frequency of the condition. 



It is not improbable that the organisms may go undetected more 

 commonly than is generally supposed to be the case because of the 

 fact that a majority of the sputa examined microscopically are stained 

 by Gabbett's method or some similar procedure. While the spiral or- 

 ganisms in pulmonary spirochaetosis stain well with ordinary aniline 

 dyes, such as carbol-fuchsin or Loeffler's methylene-blue, we found that 



