GRANULOMA INGUINALE 



2193 



Markham Carter, in 1910, described the parasites as ' bean-shaped 

 bodies resembling the gregariniform stage of a herpetomonas or a 

 crithidium, ' and came to the conclusion that the affection was due 

 to either a herpetomonas or a crithidium. 



Flu, in 1911, in South America confirmed Siebert's work, but 

 considered the bodies to be bacilli, with capsules, and not cocci. At 

 the same time, however, he called attention to the possibility of 

 the bodies being a stage of a chlamydozoal infection. Martini, in 

 1913, announced that he had succeeded in cultivating the germs 

 described by vSiebert and Flu on blood agar. He described them as 

 anaerobic, capsulated. Gram-negative diplococci, and stated that 

 he had succeeded in producing granulomata in mice by inoculation 

 of cultures, though he failed with guinea-pigs and rabbits. In the 

 same year Aragao and Vianna also stated that they had succeeded 

 in growing the bodies, which they considered to be of bacterial 

 nature, using the term ' calimmato-bacterium granulomatis.' Their 

 work was confirmed by De Souza Araujo. 



It is very doubtful whether the cultures obtained by all these 

 observers are in reality cultures of Donovan's bodies. The inocula- 

 tion of vaccines made from such cultures do not induce any im- 

 provement. 



Wise, in 1907, found in the eruption spirochaetes resembling Treponema 

 pallidum and Spiroschaudinnia refringens, together with small bodies con- 

 sisting of a thin capsule surrounding a clear unstained space, in the middle of 

 which was a curved chromatic rod, which was thinner in the centre and 

 club-shaped at either end. He found from two to twenty-five of these in the 

 leucocytes. Cleland confirmed Wise's observations, and called the spirochaete 

 5. aboriginalis Cleland, 1909. 



Bosanquet confirmed the presence of spirochaetes in sections, associated 

 with numerous bacteria, but did not consider the spirochaetes to be the aetio- 

 logical agents of the affection. De Souza Araujo observed that after the 

 injection of salvarsan the spirochaetes disappeared, but the condition did not 

 get better; hence he came to the conclusion that the spirochaetes had nothing 

 to do with the aetiology of the disease. 



Cleland and Hickinbotham, in 1909, published further observations on 

 granuloma inguinale, and stated that spirochaetes were present only in a 

 certain number of cases, while they constantly found large numbers of diplo- 

 bacillary bodies. Le Dantec, in 191 1, was still of opinion that the malady 

 was of tubercular origin. Torre and Rabello believed it to be a form of sporo- 

 trichosis, and Greco a blastomycosis. Pijper, in a recent interesting publica- 

 tion, has definitely brought forward a chlamydozoon theory, and considers 

 that the variously shaped bodies described by so many observers are stages 

 of the same organism, a stage of which, in Pijper's opinion, closely resembles 

 the initial or elementary bodies described by Prowazek in the development of 

 the Guarnieri bodies. 



Communicabiiity. — The disease is generally transmitted by sexual 

 intercourse. 



Cleland states that in West Australia the malady is especially common 

 among ' gins ' (native women), and there is an idea prevalent among the 

 white settlers that the girls become infected by connection with dogs, in which 

 animals a condition similar or identical with granuloma venereum is said to be 

 found. Ernest Black, who has made a thorough investigation, states that 

 Cleland's hypothesis is untenable. 



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