184 The Philippine Journal of Science 1918 



actually be a comparatively highly differentiated phase of an 

 organism not to be demonstrated morphologically in the lesion 

 to which it gives rise. 



In what form such an organism would maintain itself in the 

 tissues is not evident from the findings. If it is as a formed 

 body, it probably resembles so closely some tissue cell as to be 

 indistinguishable morphologically or tinctorially. The alter- 

 native is that it occurs as a body or substance with little or no 

 morphological differentiation, whether maintained intra- or 

 extra-cellularly. The observed development of the peculiar 

 basic forms from tissue elements in cultures, in conjunction 

 with certain of the findings in the lesion, suggests the exist- 

 ence of an amorphous intracellular substance that is passed on 

 from cell to cell by disintegration of those infected. The granules 

 and shreds seen in some of the tissue sections (as in figs. 13, 

 14, and 15), and the peculiarly orderly fragmentation of degen- 

 erating leucocyte nuclei sometimes seen in older areas (figs. 18 

 to 28), might play a part in such a process. Such a substance 

 would be, in effect, a localized, nondiffusible "virus" and would 

 perhaps be midway between organisms of fixed morphology and 

 the recognized filterable viruses that are known only by their 

 constitutional effects. 



The difficulty of determining whether or not the tissue or 

 cultural cell fragments are of pathogenic significance, and not 

 simply negligible degeneration products, is obvious. The frag- 

 mentation seen in sections, though interesting, is by accepted 

 standards ascribable solely to pycnotic degeneration (chromoly- 

 sis) and does not suggest any vital process. Further, in pre- 

 parations from cultures none but the clear-cut basic forms are 

 at all convincing as of possible significance; the lesser forms 

 usually appear as negligible fragments of tissue cells that are 

 often seen on the special media employed. However, the de- 

 velopment of the denser forms and their persistence in spite 

 of very unfavorable influences where developed distinguish them 

 as of more than incidental importance. 



The contagiousness of this infection is very slight or nil. No 

 history of contact with previous cases or of subsequent infection 

 of other individuals could be obtained. Were the exudate very 

 infectious, this would be a simple matter because of intimacy 

 and extreme hygienic simplicity of barrio life among this class 

 of Filipinos. From the viewpoint of the suggested etiology of 

 the lesion it may be that the invader, after adaptation between 

 itself and the host became established, and while losing its mor- 



