498 Relapsing Fever 



of blood containing them in 3 to 5 cc. of citrated rat or human 

 blood. A third generation always failed. 



Noguchi* was the first to achieve the successful cultivation of 

 the spirochseta in artificial culture media. The best success was 

 obtained as follows: Into each of a number of sterile test-tubes 

 2 X 20 cm. in size is placed a fragment of fresh sterile rabbit kidney 

 and then a few drops of citrated blood from the heart of an infected 

 mouse or rat. Following this, about 15 cm. of sterile ascitic or 

 hydrocele fluid are quickly poured into the tubes and the contents 

 of some of the tubes are covered with a layer of sterile paraffine 

 oil, while the rest are left without the oil. The tubes are placed in 

 the incubating oven at 37°C. By these means cultures of Spiro- 

 chseta duttoni, Spirochseta kochi, Spirochaeta obermeieri and Spiro- 

 chseta novyi were secured. The maximum growth was obtained in 

 7, 8 or 9 days at 37°C. The presence of some oxygen seemed to be 

 essential. By transplantations to fresh media of the same kind 

 they were all kept growing for many generations during which they 

 did not lose their virulence. 



Mode of Infection. — -The means by which Spirochseta obermeieri 

 is transmitted from individual to individual is not definitely known. 

 Tictinf seems to have been the first to believe that the transmission 

 of the disease was accomplished through the intermediation of some 

 blood-sucking insect. He investigated lice, fleas, and bed-bugs, 

 in the latter of which he was able to find the organisms, and through 

 blood obtained from which he was able to transmit the disease to 

 an ape. He was not able to infect apes by permitting infected 

 bed-bugs to bite them. Breinl and Kinghorn and ToddJ made a 

 careful study of the subject, but, like Tictin and their other prede- 

 cessors, were unable to infect monkeys by permitting infected bed- 

 bugs to bite them. 



Mackie,§ Graham-Smith, || Bousfield,** Ed. Sergent and H.Foley, ft 

 studied the louse and found that it was undoubtedly capable of 

 acting as a transmitting agent, and possibly was the only definitive 

 host of the parasite. Nicolle, Blaizot and ConseilJJ studied the 

 North African relapsing fever of Tunis and Algeria, and proved that 

 the body and head lice are undoubtedly the common definition hosts 

 of its spirochaete. When the lice were fed upon blood of infected 

 patients, the spirochsetes rapidly disappear in their bodies, but after 

 eight days reappear and remain for almost twelve days during which 

 time the insects can transmit the disease. They also found that the 



* "Journal of Experimental Medicine," 1912, xvi, 199. 



t "Centralbl. f. Bakt. u. Parasitenk.," 1894, i Abt., xv, p. 840. 



j Ibid., Oct., 1906, xui, Heft 6, p. 537. 



§ "Brit. Med. Jour.," Dec. 14, 1907. 



II "Ann. de I'Inst. Pasteur," igio, p. 63. 

 ** Report of the Wellcome Tropical Research Laboratories, 1911, p- 63- 

 ft "Ann. de I'Inst. Pasteur," 1910, p. 337. 

 it "Ann. de I'Inst. Pasteur," Mar. 25, 1913, vol. xxvii, No. 3, p. 204. 



