452 Vincent's Angina 



always took faint but uniform coloring, varied in length, and showed 

 such irregular and non-uniform undulations as to appear more ser- 

 pentine than "corkscrew-Uke." They seem never to occur without 

 associated fusiform bacilli. The writers believe these organisms and 

 not the bacilU to be the cause of the angina, but the relation of the 

 organisms to one another and to the morbid conditions with which 

 they were associated was a point long under debate, since none of 

 those studying either organism succeeded in artificially cultivating it. 



Relation of the Organisms to One Another 



We have, in Vincent's angina, to do with two micro-organisms that 

 occur in habitual association. Neither was found to be cultivable 

 by the earher writers. The spirochseta could not be cultivated by 

 Vincent, and of the various fusiform bacilli, one found by Babes in 

 scurvy, which was obviously different from the others, was alone sus- 

 ceptible of cultivation. Later, however, reports were made of the 

 growth of the organisms in mixed cultures. Still later, Veillon and 

 Zuber, EUermann, Weaver, and Tunnicliff were able to secure pure 

 cultures of the fusiform bacillus. Quite a number of writers reached 

 the conclusion that the organisms were not different, but were dif- 

 ferent stages of the same organism. Tunnicliff* found that in pure 

 cultures of Bacillus fusiformis, after forty-eight hours, spiral organ- 

 isms resembling those seen in smear preparations from the original 

 source were found. From Tunnicliff's results it would seem as 

 though Bacillus fusiformis and Spirochaeta vincenti are identical 

 organisms in different stages of their life-history. But the matter 

 is not yet settled for Krumwiede and Pratt t by a different method of 

 cultivation have apparently obtained B. fusiformis pure — i.e., free 

 from the spirochaeta — have not found any apparent transformation 

 of the bacilli into spirochaeta, and insist that the two are essentially 

 different organisms. 



Morphology. — The Bacillus fusiformis presents the same appear- 

 ances, no matter what medium it grows upon. It measures 3 to lo // 

 in length, 0.3 to 0.8 ^ in thickness. The greatest diameter is at the 

 center, from which the organisms gradually taper to blunt or pointed 

 extremities. 



The organisms stain with Loffler's alkaline methylene blue, with 

 diluted carbol-fuchsin, by Gram's method, and by Giemsa's method. 

 The staining is intense, but is rarely uniform, the substance usually 

 being interrupted by vacuoles or fractures, reminding one of those 

 seen in the diphtheria and tubercle bacilli. According to Tunnicliff, 

 the bacilli form endospores sometimes situated at the center, but 

 more frequently toward one end. Krumwiede and Pratt never ob- 

 served spores. In twenty-four to forty-eight hours filaments are 



* "Jour, of Infectious Diseases," 1906, ni, 148. 

 f'Jour. of Infectious Diseases," 1913, xni, 438. 



