Pathogenesis 455 



lus appeared in the form of delicately whitish colonies, 0.5 to 2 mm. in 

 diameter, resembhng colonies of streptococci. By transplanting 

 these, pure cultures of Bacillus fusiformis were obtained. In the 

 transplantation tubes the organism again grew in the form of similar 

 whitish colonies, a flocculent deposit accumulating at the bottom of 

 the water of condensation. 



Loffler's Blood-serum Mixture. — After twenty-four to forty-eight 

 hours similar colonies appear and a similar flocculent deposit collects 

 in the condensation water. 



Rabbit's Blood Agar-agar. — The growth is similar, but brownish in 

 color. 



Glycerin Agar-agar. — No growth. 



Glucose Agar-agar Stab. — ^A delicate whitish growth with small 

 lateral prolongations develops along the path of the wire in twenty- 

 four to forty-eight hours. Some gas is formed. 



Litmus Milk. — In forty-eight hours there is a moderate growth. 

 The Utmus becomes decolorized. There is no coagulation. When 

 oxygen is admitted the medium regains its lost color. 



Potato. — No growth. 



Bouillon and Dextrin-free Bouillon. — No growth. 



Glucose-bouillon. — No growth when more than i per cent, of glu- 

 cose is present. The medium is clouded with some sediment. No 

 gas was produced in dextrose, galactose or levulose, but gas is some- 

 times produced in saccharose. All of the carbohydrates gave rise to 

 acidity of the culture media. 



From all of the cultures a somewhat offensive odor is given 

 ofi. 



Pathogenesis.^ — Pure cultures of the organisms were inoculated 

 into guinea-pigs without result. As in Vincent's angina the throat 

 always contains staphylococci and streptococci, and not infrequently 

 diphtheria bacilli, it is thought by many that Bacillus fusiformis does 

 not initiate the morbid process, but is a secondary invader, by which 

 simpler inflammations are intensified and made necrotic. 



This seems to be particularly true of diphtheria, and may account 

 for the occurrence of noma, in which gangrenous condition of the 

 mouth and genitals the organisms have been found in great 

 numbers. 



Bacillus fusiformis, with the associated spirals are not confined to 

 Vincent's angina, but are found in a variety of other necrotic and 

 gangrenous affections. Vincent* himself found them in all cases of 

 hospital gangrene; Veillon and Zuber,t found them in certain cases 

 of appendicitis; Bernheim and PopischellJ in gangrenous laryngitis; 

 Silberschmidt§ in fetid brochitis; Freejmuth and Petruschky,|| 



* "Ann. del' Inst. Pasteur," 1896, x, 488. 

 t "Archiv. de med. Exp.," 1898, p. 517- 

 i"Jahresb. fur Kinderheilkunde," 1898, xlv. 

 § "Centralbl. f. Bakt., etc.," 1901, Orig., xxx, 159. 

 II "Deutsche med. Wochenschrift," 1898, p. 232. 



