490 THE HEMORRHAGIC DIATHESES 



the liver, spleen and kidneys; (e) hemorrhagic portions of the intestine; (/) 

 lymph-glands from the thoracic and abdominal cavities. 



In the sections from the large hardened glands of the abdomen, as well as 

 in the hemorrhagic cutaneous areas, there was found, after staining with 

 methylene-blue and after the Gram-Weigert process, a moderately large 

 bacillus averaging from 1-3 /x in length and 0.8 /j, in breadth with rounded 

 ends. The bacilli were especially profuse in the spleen, some in the small 

 blood- and lymph-vessels forming larger clumps, some also in the interstitial 

 tissue, though here not so numerous as in the vessels, but found lying sepa- 

 rated from one another; now and then longer threads were found due to a 

 Juxtaposition of the individual bacilli end to end. For the most part two rods 

 were found placed together lengthwise (diplobacilli) . In the kidneys the bacilli 

 were mostly met with in the glomeruli, but were here not so numerous as in 

 the spleen. It was also possible to find the bacillus in sections from the liver, 

 and in sections of cutaneous hemorrhagic areas in which, even in the lowest 

 cellular layer of the corium, scattered bacilli were found. Particularly in- 

 structive pictures were furnished by sections of hemorrhagic glands. In fresh 

 sections from organs the same variety of bacteria was demonstrated. The 

 bacillus hemorrhagicus Kolb flourishes upon gelatin. The matured colonies 

 are circular in form, with many constrictions and serrations; in the interior 

 fine furrows are seen, and toward the border a more granular appearance 

 becomes prominent. In stab culture after a few days colonies are found 

 partly isolated, partly coalescent, with superficial flat, hyaline extensions 

 along their serrated borders. Upon inoculation a thin leaf-like distribution 

 of a whitish blue color and of porcelain-like transparency with indentations 

 and serrated borders is observed along the entire course. Kolb's bacillus grows 

 upon agar, as in the gelatin stab culture, and somewhat more slowly upon blood 

 serum. Upon potato a white, moist, glistening streak is noted along the 

 course of inoculation. In bouillon cultures a feebly alkaline medium is the 

 best. Even on the first day the solution shows a general cloudy turbidity. As 

 the growth advances the bacteria sink to the bottom. In pure culture the 

 bacillus appears as a short, oval, somewhat plump rod with rounded ends; 

 usually two are found together. Its length amounts to 0.8-1.5 /jl. The appar- 

 ent threads which are frequently observed may attain in pure culture a length 

 of 30 ft.. The bacillus has no motility, and is a facultative aerobe. 



Kolb's bacillus is pathogenic in mice, and rabbits and pigeons are suscep- 

 tible; on the other hand, guinea-pigs very rarely or never succumb to the 

 infection. In susceptible animals the clinical picture corresponds to human 

 purpura hemorrhagica. In rabbits the characteristic purpuric spots may be 

 produced with cultures free from bacteria and mice may be killed in this way. 



SPECIAL SYMPTOMATOLOGY 



The most characteristic and prominent symptom of the disease, forming 

 its distmguishing feature, and attracting most attention, is the purpura which 

 develops upon an entirely normal skin without producing any inflammatory 

 disturbance. As the areas of the skin upon which the hemorrhages appear 

 are up to the moment of their development entirely intact, we may assert with 



