﻿NOTES ON CHRONIC ULCERS. 561 



Evidence of transverse division was observed in all three classes. It 

 was indicated by a pale area between two curves or at the top of a curve 

 near the middle of the organism (PL 1, fig. 1, a), or at two points in 

 the same organism, dividing it into thirds. The pale area appeared to 

 be narrower than the rest of the body. This is particularly well shown 

 in examples of Class A, when the division, if such it be, is nearly com- 

 plete. It might be argued that two individuals happening to lie end 

 to end would produce a false impression of transverse division, but 

 against this assumption are the facts that many instances can be found 

 in a single specimen and that the line of the curve is unbroken. These 

 appearances occur, but they are by no means as distinct in Classes B 

 and C as in Class A; similar ones have been described by Goldhorn (8) 

 and Fox (5) for Treponema pallidum, and by Kovy and Knapp (7) for 

 Spirochceta obermeieri. Classes B and C also at times suggest longi- 

 tudinal division or agglutination, or both. A very few examples were 

 observed in which one end of the organism was distinctly forked. Two 

 organisms, intertwined, were not uncommonly seen, but in many of these 

 instances four separate ends could be distinguished, so that the arrange- 

 ment might have come about either by longitudinal division or by 

 agglutination. One large bundle of organisms of Class C was observed, 

 the individuals being arranged nearly parallel to each other. One 

 spirochceta projecting from the side of the bundle showed a' forked 

 extremity, with the junction of the ends entirely clear of the bundle 

 where it could plainly be seen. As the number of specimens which I 

 have examined is a small one, these data on the question of multiplication 

 of spirochaitw are not considered to be sufficient to prove the occurrence 

 of either form of division. 



I could not establish the causal relationship between the spirochceta? 

 and the ulcers. 



SUMMARY. 



Four different types of ulceration were studied. The first and second 

 types were not definitely diagnosed. They Avere probably infections 

 sui generis. In the third type the weight of evidence is slightly in favor 

 of syphilis. Many examples of this were seen. In the fourth type the 

 probability of syphilis is strong. The remaining cases of the series 

 seem to be variations of types three and four, which might all be placed 

 in one group. Together they would comprise 94 per cent of the series 

 (thirty-two cases). The diagnoses were all made clinically, because the 

 microscopical findings were negative or ambiguous. 



The cellular content of the exudates was nearly the same in all the 

 cases. The bacteria, were as a rule also identical. 



Blastomyces were found in the exudate from two cases, but were not 

 proved to be of etiological importance. 



