J. W. S. Macfie 
287 
tlie study of my whole series of examinations convinced me had taken 
place. I do not think a similar intracellular phase of any other human 
spirochaete has been described. 
A very interesting controversy has sprung up with regard to the 
granule phase of spirochaetes which has been ably summarised by 
Fantham (1914). The formation of coccoid bodies has been observed 
in spirochaetes inhabiting the blood of vertebrates, the digestive tract 
and crystalline style of molluscs, the human mouth and intestine, etc., 
as well as in invertebrate hosts. Some observers have regarded these 
granules as degenerative, but their views have been criticised by 
Fantham (IDM), and there can I think be little doubt that they are 
in reality developmental. They have repeatedly been described as 
growing into spirochaetes in the host, and in vitro the same development 
has been observed by Noguchi (1912) and Balfour (1913). In cultures 
by Bass’s method of a spirochaete isolated from a guinea-pig’s blood 
I have myself observed that subculture was successful when made at 
a time when no living organisms could be found but only granules, 
and degeneration forms. 
Although in the vertebrate the part played by the granules in the 
case of spirochaetes possessing a natural alternation of hosts is not 
completely understood, in those species which do not show such an 
alternation they appear to be the cross-infective stage of the organism; 
and in the case of the spirochaete described in this paper the coccoid 
bodies found in the parasites in the urethral discharge were probably 
of this nature. 
In the invertebrate host, the tick, Hindle (1911) described the spiro¬ 
chaetes as entering the cells before segmenting into coccoid bodies, 
whereas Balfour considered it was the granules which penetrated the 
cells. Fantham’s (1911) account of the life cycle is apparently more 
in accordance with Balfour’s view than Hindle’s. The intracellular 
phase of the urethral spirochaete described above was I believe com¬ 
parable to the development of S. gallinarum and other spirochaetes 
in the invertebrate host, and provided the organism with a means of 
rapid multiplication in addition to transverse and longitudinal division. 
The invasion of the urethral cells was probably effected in this case 
by the spirochaetes themselves and not by the granules, but once 
within the cytoplasm coccoid bodies were formed, multiplied, and 
developed into a fresh generation of spirochaetes. It was I think 
the occurrence of this intracellular phase which determined the onset 
of the urethritis. 
