J. W. S. Macfie 
289 
perhaps Spirochaeta refringens in the discharge. The spirochaetes 
found in this case had a membrane so that they were not treponematas, 
but this is not perhaps of such great significance as is supposed, and 
Fantham commenting on the observation of granules in T. pallidum 
by Balfour suggests that this organism may be “really a member 
of the genus Spirochaeta, too minute for observation of a membrane 
or internal chromatin granules, and so its coils may only appear to 
be fixed.” In other respects also the parasites differed from T. pallidum, 
and as the clinical history, symptoms, and duration of the urethritis 
were not suggestive of a urethral chancre, I think the idea that the 
condition was due to syphilis may be dismissed. 
Of the other spirochaetes associated with genital lesions S. refringens 
and S. halanitidis are those most closely resembling this organism. 
These two species are considered by some writers (Rille, Kraus) to be 
the same, others believe them to be distinct (Hoffmann and Prowazek), 
and Eitner, Richards and Hunt conclude that more than one species 
is included under the name S. refringens. There is some doubt whether 
either species is truly pathogenic, although Baermann- has furnished 
evidence that S. refringens may spread beyond the superficial lesions, 
and Hoffmann and Prowazek believe S. halanitidis to be the causal 
organism of balanitis. 
It is at least clear, I think, that the spirochaete I have described 
was not a mere saprophyte but actually invaded the cells lining the 
urethra setting up an acute inflammatory condition. The intracellular 
phase I have observed distinguishes the parasite from any of those 
previously described, and I therefore propose for it the name Spdrochaeta 
urethrae. 
A Note on the Measueement op the Length op Spieochaetes. 
Spirochaetes undoubtedly vary very greatly and under different 
conditions assume different forms and show different types of motility 
so that it is difficult to select any characters or measurements that 
may be considered typical of the organisms. 
According to Bosanquet (1911) Krienitz in 1906 found that in the 
case of S. microgyrata “ the form of the organism changed with changing 
conditions, the alterations involving both length, thickness, and arrange¬ 
ment of curls” and that in consequence he “doubts the possibility 
of distinguishing spirochaetes by their morphological characters alone.” 
