ASSOCIATED SPIROCH^T^ AND FUSIFORM BACILLI. 497 



they were not acid fast and that they did not stain with the sulphuric- 

 acid-methylene-hlue as ordinarily used in Oabbett's method for demon- 

 strating tubercle bacilli. The same was found to be true for the 

 spirochsetse in Vincent's angina. Therefore, ■ it is evident that spiro- 

 chastas in the sputum would be likel}^ to be overlooked in making a routine 

 examination of the sputum for tubercle bacilli. 



The occurrence of the organisms in infections of the skin in temperate 

 regions up to the present time has been repoi'ted but rarely and no 

 estimate can be formed as to the frequency of such lesions. The cases 

 reported by Peters and Hultgen are referred to in the second paragraph 

 of this article. 



CONCLUSIONS. 



From our limited series of observations it appears probable that more 

 tlian one-half of the throat and mouth ulcers one is likely to encounter 

 in the Philippines will show fusiform bacilli and spirochsetae in greater 

 or less numbers, and that one-third of the cases will have them in prepon- 

 derating numbers. This is a somewhat higher rate than we have ever 

 seen reported in temperate climates. However, it must be remembered 

 that in all of the cases examined we were on the lookout for these par- 

 ticular parasites. The associated spirochsetae and fusiform bacilli have 

 been found in an ulcer of the skin and in 2 eases of pulmonary disease, 

 but as yet there is no evidence to show that in the Philippines they are 

 common in these situations. 



One caution needs to be given. In our opinion the finding of fusiform 

 bacilli and spirochaetae in a throat lesion does not justify one in resting 

 content with a diagnosis of "Vincent's Angina." Experience shows that 

 sj'philis, diphtheria, carcinoma, (and very probably other etiologic factors) 

 must be carefully niled out. It is still an open question whether the 

 associated fusiform bacilli and spiroch^tae are ever causative of the mul- 

 tiform lesions in which they are so often found to be present. 



REFERENCES. 



( 1 ) Chamberlain, W. P., Bloombergh, H. D., and Kilbourne, E. D. Report of 



the Board for the Study of Tropical Diseases. Mil. Surgeon (1911), 

 27, 157. 



(2) Bloombergh, H. D. Vincent's Angina. Bull. Manila Med. 8oc. (1910), 



2, 180. 



(3) Plaut. Deut. Med. Woch. (1894), 49. 



(4) Vincent. Ann de I'Inst. Pasteur (1896). 



(5) Weaver, G. H., and Tunnicliff, R. Uleero-membraneous Angina and 



Stomatitis. Journ. Am.. Med. Assoc. (1906), 46, 481. 



(6) Shattuck, C. S. Notes on Chronic Ulcers Occurring in the Philippines. 



Phil. Journ. Sci., Sec. B (1907), 2, 551. 



