FUSIFORM ANAEROBIC BACILLI 459 



irregular curves, and are motile ; in appearance they resemble 

 the spirochete refringens and similar organisms found in gan- 

 grenous conditions. They stain less deeply than the bacilli. 

 Sometimes they are numerous, sometimes scanty ; they seem to 

 be similar to spirochetes found in the mouth in a variety of 

 other conditions. In a section through the false membrane, 

 when stained -with methylene or thionin blue, there is usually to 

 be seen a darkly stained band, a short distance below the surface, 

 which is due to the presence of large masses of the fusiform 

 bacilli closely packed' together ; neither they nor the spirochetes 

 appear to pass deeply into the tissues. Vincent's results have 

 been confirmed by others, and there is no doubt that fusiform 

 bacilli, of which there are probably several species, are associated 

 with various spreading necrotic conditions. During the war, 

 cases of Vincent's angina have been of common occurrence and 

 have been met with in small epidemics. Ulcerative gingivitis and 

 stomatitis have been found to be associated with the presence of 

 the same organisms, and in some cases these lesions precede the 

 infection of the fauces. It would be advisable to apply the 

 term " Vincent's disease," as suggested by Bowman, so as to 

 include all the lesions produced by the organisms in question. 

 In phagedenic lesions of the genitals, fusiform bacilli are usually 

 present, with or without spirochetes, though in our experience 

 they are as a rule of smaller size than those met with in the 

 throat. Cultures of fusiform bacilli have been obtained by 

 Ellermann, by Weaver and Tunnicliffe, and by others. They 

 grow only under anaerobic conditions, and the best media are 

 those consisting of a mixture of serum or blood and agar (1 : 3). 

 The organisms form small rounded colonies of whitish or 

 yellowish colour, somewhat like those of a streptococcus, but 

 rather felted in appearance on the surface. Injections of pure 

 cultures in animals sometimes produce suppuration but never 

 necrosis (Ellermann). Tunnicliffe finds that the spirochsetes are 

 only stages in the development of fusiform bacilli, as cultures 

 which at an early stage show only fusiform bacilli, afterwards 

 contain spirochetes, and intermediate forms can be found. 

 There seems to be no doubt that in cultures the bacilli grow out 

 into long filaments which may have an undulated appearance ; 

 but it is doubtful whether these are to be regarded as true spiro- 

 chetes, and still more whether they are the same spirochetes as 

 those seen in the lesions in association with the bacilli. It is 

 also to be noted that fusiform bacilli are sometimes present in 

 the secretions of the mouth in normal conditions, and may occur 

 in increased numbers in true diphtheria. 



