524 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 spirochaeta 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 paraffin 

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

 the incubating oven at 3 7°C. By these means cultures of Spirochaeta 

 duttoni, Spirochaeta kochi, Spirochaeta recurrentis and Spirochaeta 

 novyi were secured. The maximum growth was obtained in 7, 8 or 

 9 days at 3 7°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 Spirochaeta recurrentis 

 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 Kce, 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 Toddt 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 capa- 

 ble of acting as a transmitting agent, and possibly was the only de- 

 finitive host of the parasite. NicoUe, Blaizot and Conseillt 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 Uce were fed upon blood of in- 

 fected patients, the spirochaetes 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 



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



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



t Ibid., Oct., 1906, xtn, Heft 6, p. 537. 



§ "Brit. Med. Jouf.," Dec. 14, 1907. 



II "Ann. de I'Inst. Pasteur," 1910, 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. xxvn, No. 3, p. 204. 



