66 



SPIROCHETES 



even a slight touch is unbearable. Usually the spirochsetes are 

 abundant in the liver, suprarenals, blood and other organs and 

 tissues during this initial "febrile" stage of the disease, but they 

 are destroyed in the liver and suprarenals by antibodies usually 

 by the seventh day. During the second week of the disease, 

 termed the "icteric " stage, the fever subsides and marked jaundice, 

 accompanied by swelling and pain in the liver, usually appears, 

 though this symptom is sometimes evident as early as the third 

 day. In some cases, in Europe at least, jaundice may not appear 

 at all. The fever usually reappears in milder form about the 

 end of the second week, but it is of short duration. Such symp- 

 toms as vomiting, nose bleed, upsetting of the digestive system, 

 swollen spleen, weak but rapid pulse, and meningitis are usually 

 associated with the disease, and kidney trouble is nearly always 

 present, and is sometimes more severe than the jaundice. A 



tendency for the mucous 

 membranes and various 

 organs to bleed is a common 

 and dangerous symptom. 

 During the icteric stage of 

 the disease the spirochsetes 

 disappear from the blood, 

 and are gradually destroyed 

 in other parts of the body; 

 they persist longest in the 

 kidneys, since the antibodies 

 which destroy them else- 

 where are apparently ineffec- 

 tual against those situated 

 in the kidney tubules. They 

 continue to be excreted with 

 the urine for six or seven 

 weeks, though nearly all symptoms usually disappear much earlier. 

 If death occurs, it nearly always comes between the eighth and 

 sixteenth days of illness. The disease is said to be not as severe 

 in Europe as in Japan, the mortality among infected soldiers in 

 Flanders being less than six per cent. 



The spirochsetes are found in the blood, the cerebrospinal fluid, 

 and in many of the tissues of the body, especially the liver and the 

 kidneys. They vary in length from only four or five /x to 20 //, 



Fio. 11. Liver of patient who died from 

 Weil's disease on sixtli day, showing Spiro- 

 chwta icterohemorrhagice in tissue. X 200. 

 (Slcetched from figure by Inada et al.) 



