SPIROCHETAL OR INFECTIVE JAUNDICE 525 



siderable numbers, especially in the epidermis and also amongst 

 the leucocytic infiltration, which comprises more polymorpho- 

 nuclear leucocytes than are seen in the case of syphilis. Castellani 

 showed that the disease could be transferred to monkeys (semno- 

 pithecus and tnacacus being used for this purpose), and that the 

 organism could be demonstrated in the unbroken skin lesions. 

 The lesions are as a rule confined to the site of inoculation, but 

 the infection is general, as is shown by the presence of spirochetes 

 in the lymphatic glands and the spleen. These results with 

 regard to the presence of spirochaste pertenuis in the lesions and 

 the inoculation of apes have been confirmed by other workers, 

 and the etiological relationship of the organism to the disease 

 may now be regarded as established. Nichols has shown that 

 a frambcesia lesion can be produced in the testicle of the rabbit 

 of similar character to the syphilitic lesion, though the period 

 of incubation is shorter. He finds that the best means of dis- 

 tinguishing the two diseases is afforded by inoculating the skin 

 of the monkey. In the case of syphilis the resulting lesion is 

 fiat, dry, and very scaly ; in the case of frambcesia it is elevated, 

 slightly scaly, and very oedematous ; here also the period of 

 incubation is shorter in the case of frambcesia. The immunity 

 reactions in monkeys infected with syphilis and framboesia, as 

 experimentally studied by Castellani and by Neisser, Baermann, 

 and Halberstadter, go to show that the two diseases are distinct. 

 Nichols obtained a corresponding result in the case of the rabbit, 

 as he found that this animal, when cured of a syphilitic lesion 

 of the testicle by means of salvarsan, was susceptible to framboesia 

 but not to syphilis. On the other hand, Levaditi and Nattan- 

 Larrier found that, although monkeys infected with syphilis 

 were refractory to framboesia {Fr. pian), monkeys infected with 

 frambcesia were susceptible to syphilis : they therefore concluded 

 that frambcesia is a modified or mild form of syphilis. We may 

 add that patients suffering from frambcesia generally give a positive 

 Wassermann reaction ; they are also very amenable to treatment 

 with salvarsan (Alston and others). The exact relationship of 

 the two diseases cannot be yet accurately defined, but they are 

 probably distinct, though undoubtedly closely related. 



Spirochetal or Infective Jaundice. 



This affection, often known as Weil's disease, was proved in 

 1915 by Inada and other Japanese workers to be due to a 

 spirochete, to which -they gave the name spirochete ictero- 

 hcBmorrhagice, and already the pathology of the condition 



