BRONCHIAL SPIROCHETOSIS 



1883 



Galli Valerio recorded several interesting cases of the malady in 

 Switzerland, and Lurie one in Serbia, In 1917 Galli Valerio recorded 

 further cases in Switzerland. In 1917 VioUe first discovered the 

 affection in France, making a very complete investigation and 

 publishing numerous papers on it. Violle's observations stimulated 

 further research in France, and a number of cases of the malady 

 were reported by Bine, Dide, and Ribereau, by Netter, by Dalimier, 

 by Barbary, and others. Alcock has described a case in an English 

 soldier in the North of Italy. Villa and, later, Corvetto have 

 recorded cases in South America. 



Geographical. — The disease has probably a cosmopolitan dis- 

 tribution. It has been found in Ceylon, India, Phihppine Islands, 

 China and ' Indo-China, North and Equatorial Africa, being 

 especially common in the Sudan, West Indies, America, and 

 recently in Europe in the Balkans, Italy, Switzerland, France, and 

 England. 



etiology. — ^The disease is due to S. bronchialis Castellani, 

 1907. The parasite has been further investigated by several 

 observers, and in a masterly manner, in 1914, by Fantham, who 

 described its coccoid and intracellular stages. The organism is 

 extremely polymorphic, being very variable in length, thickness, 

 and the number of waves. One may distinguish thick and thin 

 forms, long, short, and intermediate types. The length may vary 

 between 5 and 30 microns, its breadth between 0-2 and 0-6 micron. 

 A number of the parasites are between 14 and 16 microns, or 7 and 10 

 microns, the latter resulting, as shown by Fantham, from transverse 

 division of the former. 



The ends are of variable shape, but mostly somewhat acuminate. 



The number of spirals varies between two and eight. Flagella 

 seem to be absent, but Fantham has noticed the presence of a 

 delicate membrane or ' crista ' in certain specimens. 



In fresh preparations S. bronchialis is actively motile for only a 

 short time; the motile phase, as demonstrated by Fantham, is suc- 

 ceeded by one of granule formation the granules or coccoid bodies 

 representing a resting stage from which new spirochaetes develop. 

 Fantham has carefully compared 5. bronchialis with the common 

 mouth spirochaetes, and has come to the conclusion that they differ 

 in several features. S, bronchialis is more actively motile than the 

 oral spirochaetes; it dies, as observed first byChalmers andO'Farrell, 

 and later by Taylor, very quickly in fresh preparations, while the 

 oral spirochaetes may live for hours outside the human mouth. 

 Coccoid bodies are much more frequently produced by 5. bronchialis 

 than by the spirochaetes of the mouth. Intracellular stages are 

 occasionally seen in the case of 5. bronchialis, but not in the case of 

 spirochaetes from the mouth. 5. bronchialis stains with more 

 difficulty than the oral spirochaetes, is slenderer than one of them, 

 S. buccalis, and does not appear to produce pseudo-membranes. 



Predisposing Causes. — A chill acts, in our experience, as a very 

 important predisposing or secondary cause. 



