. 528 SPIROCHETAL OR INFECTIVE JAUNDICE 



This does not occur in the earliest stage of the disease, but from 

 about the tenth day onwards positive results are obtained in in- 

 creasing numbers, till about the twentieth day it may be found 

 in practically all cases. Thereafter it gradually disappears, and 

 is rarely found after the fortieth day. The best method is to 

 examine by dark-ground illumination the deposit thrown down 

 from the urine by a high-speed centrifuge. 



The gradual development of anti-substances in the blood has 

 been shown to occur during the disease. These appear towards 

 the end of the first week, and seem to be related to the 

 disappearance of the organism from the blood ; they become 

 specially marked during the second week. Their presence 

 can be demonstrated by injecting some of the patient's serum 

 along with the spirochaetes into a guinea-pig, death being thus 

 prevented, or at least the onset of the illness being postponed. 

 Destruction of the organisms under the influence of the anti- 

 serum may be observed in the peritoneal cavity of the animal, 

 that is, spirochsetolysis occurs, corresponding to Pfeiffer's pheno- 

 menon in the case of bacteria. 



Experimental Inoculation. — The injection of blood or of 

 emulsions of organs containing the spirochaetes into the peri- 

 toneal cavity of a guinea-pig leads to an infection which is 

 usually fatal in about seven to twelve days ; the same holds 

 with regard to the effect of pure cultures. The symptoms are 

 conjunctival congestion, anaemia, jaundice, haemorrhagic dia- 

 thesis, and albuminuria. There is pyrexia, which towards the 

 end is succeeded by subnormal temperature ; the jaundice occurs 

 somewhat late, usually about twenty-four hours before death. 

 Post mortem, there are haemorrhages in the lungs, intestinal 

 walls, and retro-peritoneal tissue ; acute parenchymatous nephritis 

 is present, and the spleen is large and congested. The haemor- 

 rhages in the lungs occur as small and large spots, described as 

 being "like the wing of a mottled butterfly." The spirochaetes 

 are present in the blood and organs, and in the latter are chiefly 

 interstitial in position, few being actually within cells. In this 

 respect there is a difference from what obtains in the human 

 disease. They are most abundant in the liver, where they may 

 be arranged like a garland round the liver cells. The adrenals 

 and the kidneys contain considerable numbers, but they are 

 scanty in the spleen, bone-marrow, and lymphatic glands. The 

 Japanese workers believe that, in the human disease, infection 

 occurs chiefly through the alimentary tract, and they were able 

 to produce the disease in the guinea-pig by feeding with material 

 containing the organism or by introducing some of it into the 



