MORBUS MACULOSUS WERLHOFII 461 



with the large oval structures of the bacillus anthraeis, are very small and 

 perfectly round. The bacillus purpuras liquefies gelatin with great difficulty— 

 scarcely at all— and only at high temperatures (35° to 30° C.) in the surround- 

 ing of the ilocculi (colonies). 



In the petechife of man and of the experimental animals a sheath-like 

 arrangement of the bacilli, sometimes with segmentation, is noted in foci; 

 these frequently are found equidistant from each other, not lying closely 

 together, and are spores beginning to develop. 



The surface of the stab in Koch's nutritive gelatin shows flat crescentic 

 grooves which are only recognizable upon close observation. 



The chemical differences must also be mentioned. The bacillus purpura 

 does not form so toxic a substance (toxin) as the bacillus anthraeis, but only 

 a feebly acting ptomain corresponding with the slight evening rises in tem- 

 perature that now and then occur. Pure purpura differs in this respect from 

 the acute forms of purpura (petechias) usually observed in the course of the 

 infectious diseases, as these owe their origin to other microorganisms. 



Even with cultures of the third relapse, Letzerich produced purpura in 

 rabbits. In sections, through small petechise in the transverse section of the 

 capillary net, and also where dichotomous branches pass into the lumen of the 

 same, dense proliferations of purpura bacilli were readily recognized by sim- 

 ple methylene- violet staining. 



The bacillus purpurse is not found in all the forms of its development in 

 all of the petechias. Toward the end of the disease, or during the relapse, 

 only clumps of free spores and individual bacilli are observed. Examination 

 of numerous petechias is then necessary to find the cycle of development of the 

 microorganism as described. In the relapses of the disease, particularly, we 

 frequently note emboli of spores which, upon superficial observation, may be 

 looked upon as micrococci emboli, but, upon closer study, merely from the cir- 

 cumstance that they are embedded in gelatinous plugs, their development from 

 threads and rods can be determined. 



Lockwood also believes purpura to be of an infectious nature, and the 

 bacillus described by Letzerich to be the carrier of the infection and pathogenic 

 agent. According to this author, the very acute development and the course, 

 which is similar to that of an infectious disease, favor the view of an infec- 

 tious, development, and he quoted 17 cases from literature. Of these 13 died 

 in from forty-seven hours to twenty-one days. He is also inclined to look 

 upon purpura simplex and purpura rheumatica as due to the same infection, 

 but showing a different intensity. Cases of purpura which ran a fatal course 

 in seven hours have never to my knowledge been published by others, and 

 under no circumstances can these be included among the cases of pure pur- 

 pura; the most severe case of fulminant purpura that I ever saw (to be detailed 

 later) terminated fatally in two days. 



H. Neumann cites cases of hemorrhagic diathesis of the newborn. In the 

 first case, besides the staphylococcus pyogenes aureus as in former cases, the 

 bacillus pyocyaneus P was found. He does not admit a direct relation of- the 

 latter to the hemorrhagic diathesis, but attributed the diathesis to syphilis 

 which was present. 



