1328 



TYPHUS 



Briihl described a diplococcus; in 1899 Balfour and Porter found 

 another diplococcus. In 1903 Gottschlich described a Piroplasma 

 existing in non-motile endocorpuscular and flagellate free forms 

 in cases in Egypt, but these parasites may have only been cellular 

 degenerations; and Horiachi described a bacillus which he isolated 

 from the faeces and urine of Japanese troops which in the war in 

 Manchuria suffered from a disease which was probably typhus. 

 Krompecher, Goldzieher, and Augyan have described intracorpus- 

 cular bodies somewhat resembling a Piroplasma. In 1909 Rabino- 

 witsch grew an aerobic coccobacillus ; in 1914 Hort and Ingram 

 described a pleomorphic bacillus, and in 1915 Plotz a pleomorphic 

 bacillus, the so-called B. typhi-exanthematici. In 1916 Penfold, 

 and later Miss Robertson, found a blood diphlococcus. In 1919 

 Borrel, Cantacuzene, Jonesco and Nasha have isolated a capsulated 

 cocco-bacillus somewhat similar to one previously found by Pret- 

 jetschsky. 



In 1910 Ricketts and Wilder saw some curious double bodies in 

 the blood of a number of cases. In 1913 Hegler and Prowazek saw 

 numerous long, round, and diplococcal bodies in the leucocytes 

 some time after infection began, but not at the commencement 

 thereof. These bodies are believed to be the same as those described 

 in 1905 by Rabinowitsch as ' Turkischen Reizformen.' In addition, 

 the}^ observed the forms described by Ricketts and Wilder, not 

 merely in the blood, but also in polymorphonuclear leucocytes in 

 the exudate of a blister. During convalescence the bodies agglome- 

 rate in the cells, and finally tend to disappear. Post-mortem 

 trachoma-like bodies were found in the endothelial cells of the heart, 

 the lung, the liver, and the kidney. They are found in infected 

 monkeys, but not in guinea-pigs. Infected lice were seen to contain 

 small coccoid and diplococcal bodies. These bodies are believed to be 

 Chlamydozoa, and to be allied to Lipschutz's genus Strongoplasma. 



Prowazek distinguishes them from Doehle's bodies. To sum- 

 marize, these bodies appear in the leucocytes on the third day of the 

 illness, and persist until convalescence, in one case as late as the 

 nineteenth day of the illness. These bodies are called Rickettsia 

 pyoi2)azeki Da Rocha-Lima, 1916, and according to this author are 

 never found in typhus-free lice, but can be found in lice infected 

 bv sucking infected blood; then they penetrate into the cells of the 

 alimentary canal of the louse on the fourth to fifth day after an 

 infective feed, and multiply therein, and do not reach full develop- 

 ment until the eighth to ninth day. In this situation they are very 

 small, shortly elliptical, or oval, and often lie in pairs. NoUer in 

 1916 considers that the astiological role of this organism is no longer 

 doubtful, and in 1917 Foulerton considered that it was probably a 

 phase in the evolution of the cetiological agent. In 191 9 Arkwright, 

 Bacot and Duncan confirm Da Rocha-Lima observations. Bradford, 

 Bashford, and Wilson state that they have succeeded in cultivating 

 the virus, using Noguchi's method, from the blood of two cases. 

 The virus, according to these authors, consists of minute coccus-like 



