PARASITIC DISEASES . It has See also:

• LONG, GEORGE (1800-1879)
• LONG, JOHN DAVIS (1838– )

Caused by the Pyogenetic Micrococci. Suppuration and Septicaemia. See also:

• ERYSIPELAS

See also:

• MALTA
• MALTA (or MEDITERRANEAN) FEVER

See also:

• ACTINOMYCOSIS (STREPTOTRICHOSIS)

See also:

• SCARLET

Bacillus pyocyaneus, Bacillus coli communis, and the typhoid bacillus. These organisms (the products of which, by chemical irritation, stimulate the leucocytes to See also:

• EMIGRATION (from Lat. emigrare; e, ex, out of, and migrare, to depart)

In sapraemia the toxic products of saprophytic organisms are absorbed from a gangrenous or necrotic See also:

• MASS (O.E. maesse; Fr. messe; Ger. Messe; Ital. messa; from eccl. Lat. missa)
• MASS, IN

In certain cases of streptococcic endocarditis the use of antistreptococcic serum appears to have been attended with See also:

• GOOD, JOHN MASON (1764-1827)

It has been observed that changes when injected, without the gonococci, into the anterior cancerous and other malignant tumours appear to recede under chamber of the See also:

• EYE
• EYE (O. Eng. edge, Ger. Auge; derived from an Indo-European root also seen in Lat. oc-ulus, the organ of vision (q.v.)

The virulence of the streptococcus of erysipelas, as pointed out by Fehleisen and Coley, is greatly exalted when the coccus is grown alongside the Bacillus prodigiosus and certain other saprophytic organisms which flourish at the body-temperature. It is an easier matter to See also:

• CONTROL (Fr. contrdle, older form contre rolle, from Med. Lat. contra-rotulus, a counter roll or copy of a document used to check the original; there is no instance in English of the use of " control " in this, its literal, meaning)

It is found in the pus of the urethra and in the conjunctiva lying between the See also:

• EPITHELIAL, ENDOTHELIAL

The cholera bacillus may remain alive in water for some time, but it appears to be less resistant than many of the putrefactive and saprophytic organisms. It grows better in a saline See also:

• SOLUTION (from Lat. solvere, to loosen, dissolve)

Amongst the known predisposing causes of cholera are the incautious use of purgative medicines, the use of unripe See also:

• FRUIT (through the French from the Lat. fructus; frui, to enjoy)

These dejecta contain organic material which serves as a nutriment on which infective organisms, derived from the soil and ground-water, may flourish. Not only dejecta, but also the rinsings from soiled linen and utensils used by cholera patients should be removed as soon as possible, "without allowing them to come into contact with the surface of the soil, with wells," or with vegetables and the like. The See also:

• DISCOVERY

On the other See also:

• HAND
• HAND (a word common to Teutonic languages; cf. Ger. Hand, Goth. handus)
• HAND, FERDINAND GOTTHELF (1786-185r)

A similar reaction may be obtained when a quantity of a culture of the cholera vibrio mixed with the serum derived from a guinea-pig immunized against the cholera vibrio, or from a patient convalescent from the disease, is injected into the peritoneal cavity of a guinea-pig not subjected to any preliminary treatment; and, going a step further, it was found that the See also:

• DISSOLUTION (from Lat. dissolvere, to break up into parts)

See also:

• EASTON

Ledingham, examining the 90 See also:

• FEMALE

The observations of physicians working amongst the See also:

• BRITISH

They first obtained a typhoid bacillus of fairly See also:

• CONSTANT, BENJAMIN (1845-1902)

It is recorded in favour of this method of treatment that of 4502 soldiers of the See also:

• INDIAN

This organism is distinctly pathogenetic to monkeys, and its virulence may be so increased that other animals may be affected by it. Though unable to live in clean or virgin soil, it may See also:

• LEAD
• LEAD (pronounced iced)

In an' intermittent type, in which the temperature-curve closely resembles the hectic pyrexial curve of See also:

• PHTHISIS (Gr. 49Lnns " wasting ")

The most common method of infection is by the ingestion of milk, but the milk when handled may also give rise to infection through finding its way into cuts, bruises, &c. In the goat the disease is of an extremely mild character, the clinical symptoms, which are present for two or three days only, being easily overlooked. In spite of this the goat is highly susceptible to the infection either by the various methods of inoculation or as the result of feeding with contaminated or infected material. The micrococcus is often found in the circulating blood from which it may be excreted along with the urine and faeces. In time, however, it disappears, first from the general circulation and most of the viscera, persisting longest in the spleen, kidneys and lymphatic glands. In the later stages of the disease the micrococcus is found in the milk even after it has disappeared from the above glands. It is during this stage that the milk of the goat is so dangerous, as now and again it may contain an enormous number of the specific micrococcus varying " within wide limits from day to day," although bearing " no relationship to the severity of the infection, air temperature, &c.; the presence of the Micrococcus melitensis in the milk appears to be merely the result of a See also:

• MECHANICAL

On See also:

• BOARD (O. Eng. bord)

In spite of this, trans-See also:

• MISSION

The post-mortem appearances are those of a toxic (bacterial) poisoning. Curious infarction-like masses, in which are numerous spirilla, are found in the spleen; in the liver there is evidence of acute interstitial hepatitis, with cloudy swelling of the liver cells; and similar changes occur in the See also:

• KIDNEY

It has also been found in the faeces and urine. (It is very important that these excretions from plague patients should always be most carefully disinfected.) This organism, when obtained in pure culture and inoculated into rats, mice, guinea-pigs or rabbits, produces exactly the same symptoms as does material taken fresh from the softened glands. The symptoms are local swelling, enlargement and softening of the lymphatic glands, and high fever. The difficulty of explaining the spread of plague, at one time apparently almost insuperable, has at last been overcome, as it has been found that although the acute pneumonic plague is undoubtedly highly contagious, the spread of the bubonic and septicaemic forms could not be explained on the same See also:

• HYPOTHESIS (from Gr. inrorcOivat, to put under; cf. Lat. suppositio, from sub-ponere)

At least three species of animals, two rats and the human subject, and three species of fleas are involved in this chain. The rat fleas are Pulex cheopis found in India, and Ceratophyllus fasciatus, the rat flea of See also:

• NORTHERN

Such fleas, fed on infected blood, may remain alive for three weeks, and of this period, we are told, may remain infective for fifteen days. At the first opportunity these fleas forsake the human See also:

• HOST

It has already been mentioned that the organism rapidly loses its virulence when cultivated outside the body; on the other hand, on being passed through a series of animals its virulence gradually increases. Thus may be explained the fact that in most outbreaks of plague there is an early period during which the death-rate is very low; after a time the percentage mortality is enormously increased, the virulence of the disease being very great and its course rapid. There seem to be notable differences in the degree of susceptibility of different races and different individuals, and those who have passed safely through an attack appear to have acquired a marked degree of immunity. Two methods of treatment, both of which seem to have been attended with a certain degree of success, are now being tried. Haffkine, who was the first to produce a vaccine for the treatment of cholera, prepared a vaccine of a somewhat similar type for the treatment of plague. For this the Bacillus pestis is cultivated in flasks of bouillon; to this small drops or particles of See also:

• GHEE (Hindostani ghi)

The Indian Plague Commission were satisfied that the use bf this vaccine diminishes the incidence of attacks of plague, and that, although it does not confer a complete immunity against the disease, the case mortality is lowered. They are of See also:

• OPINION (Lat. opinio, from opinari, to think)

Amongst these they had a mortality of under 15%, whilst amongst 72 patients not so treated the death-rate was over 63 %. This serum kills the bacilli and at the same time neutralizes the toxin formed during the course of the disease. The best results are obtained when large doses are given, and when the serum injected subcutaneously is thrown into the area in which the lymph flows towards the bubo. As in the case of the diphtheria antitoxic serum See also:

• JOINT (through Fr. from Lat. junctum, jungere, to join)

Like the influenza bacillus and even the diphtheria bacillus, this organism may be present in the mouth and lungs of perfectly healthy individuals, and it is only when the vitality of the system is lowered by See also:

• COLD (in O. Eng. cald and ceald, a word coming ultimately from a root cognate with the Lat. gelu, gelidus, and common in the Teutonic languages, which usually have two distinct forms for the substantive and the adjective, cf. Ger. Kolte, kalt, Dutch koude

See also:

• IVY (A.S. ifig, Ger. Epheu, perhaps connected with apium, anent)

Of 16 acute cases treated 14 received serum from patients who had already recovered from the disease, 8 of the patients recovered, 6 died, and 2 cases which received their own serum both recovered. In the presence of these anti-cerebro-spinal-fever sera the meningeal cocci become diminished in number and do not stain so readily, whilst, simultaneously, the polymorpho-nuglear leucocytes seem to be diminished in number. The serum should be given until the temperature becomes normal. Mackenzie and Martin assert that even normal human blood contains substances which are bactericidal to the meningeal coccus, but that these substances increase " in amount and activity in the blood serum of patients suffering from an acute or chronic meningococcic infection, and the serum of a patient recently recovered from an infection shows the evidence of the presence of these substances in a still greater degree." They were able to demonstrate, moreover, that the destructive action on the cocci depends on an immune body which requires the presence of a complement to complete the process. The cerebro-spinal fluid differs from the serum in that it does not contain substances which kill this meningeal coccus in vitro, nor are the immune body and complement present in the blood, found in this cerebro-spinal fluid. Hence the efficacy of the blood when it is called upon to replace the fluid in the cerebro-spinal canal. 2. Posterior basic meningitis, according to Dr Still, "is frequently seen during the first six months of life, a period at which tuberculous and epidemic cerebro-spinal meningitis are quite uncommon." The organism found in this disease resembles the diplococcus intracellularis meningitidis very closely, but differs from it in that it remains alive without recultivation for a considerably longer period. It is less pathogenetic than that organism, of which possibly it is simply a more highly saprophytic form. This is a somewhat important point, as it would See also:

• ACCOUNT
• ACCOUNT (through O. Fr. acont, Late Lat. comptum, cornputare, to calculate)

In the first it is an encapsulated organism, consisting of small oval cocci arranged in pairs or in short chains; the capsule is unstained. When the pneumococcus grows in chains—the second form—as when cultivated outside the body, on blood-serum or on agar over the surface of which a small quantity of sterile blood has been smeared, it produces very minute translucent colonies. Like Weichselbaum's bacillus, it must be recultivated every three or four days, otherwise. it soon dies out. Unlike the other forms previously described, it may, when passed through animals, become extremely virulent, very small quantities being sufficient to kill a rabbit. Although the pneumococcus is found in the majority of these cases, especially in children, suppurative meningitis may also accompany or follow the various diseases that are set up by the Streptococcus pyogenes and Streptococcus erysipelatis; whilst along with it staphylococci and the Bacillus coil communis have sometimes been found. In other cases, again, there is a mixed infection of the pneumococcus and the Streptococcus pyogenes, especially in cases of disease of the See also:

• MIDDLE

The infective agent, first observed by Pfeiffer and See also:

• CANON

These, he maintained, were perfectly distinct from the putrefactive microbes occurring in the tissues in the later stages, their colonies not growing like those of the bacillus coli communis. They grow readily on all the ordinary artificial nutrient media, as short rods with rounded ends, usually about 2 to 4µ in length and about half as broad as they are long. They are stained by Gram's method and readily by most of the aniline dyes, are ciliated, and do not liquefy gelatine. They flourish specially well alongside moulds, in the dark, in badly-ventilated, warm, moist places, and remain alive for some time in sea-water:these facts, as Sanarelli points out, may afford an explanation of the special persistence of yellow fever in old, badly-ventilated ships, and in dark, dirty and insanitary sea-coast towns. Once the organism, whatever it may be, finds its way into the system, it soon makes its presence See also:

• FELT (cognate with Ger. Filz, Du. vilt, Swed. and Dan. fill; the root is unknown; the word has given Med. Lat. filtrum, " filter ")

Treatment is principally directed towards. prevention and towards the alleviation of symptoms, though Sanarelli has hopes that an " anti "-serum may be useful. More recently S. Flexner, working with the . See also:

• AMERICAN

(or S. calopus, Meig.), after taking the blood from an infected patient is not infective immediately but only becomes capable of infecting by its bite at the end of twelve days. It would appear therefore that See also:

• RESIDENCE (Latin residere, to remain behind, to dwell, reside)

The larvae can only develop if they are left in water, though a very small amount of water will serve to keep them alive. The eggs on the other hand are very resistant, and even when removed from water may continue viable for as long a period as three months. The Stegomyia affects clean water-butts and cisterns by preference. Consequently its presence is not confined to unhygienic districts; they may, however, " seek See also:

• REFUGE

The death-rate from malaria was also greatly diminished, and by the end of 1907 the death-rate per annum amongst 45,000 workers was only 18 per 1000, a lower death-rate than is met with in many large See also:

• ENGLISH

He, however, also described streptococci as present in certain cases of diphtheria, and concluded that there must be two kinds of diphtheria, one associated with each of these organisms. In 1883 he again took up the question; and in the following year Loeffler gave a systematic description of what is now known as the Klebs-Loeffler bacillus, which was afterwards proved by Roux and Yersin and many other observers to be the causa causans of diphtheria. This bacillus is a slightly-curved rod with rounded, pointed, or See also:

• CLUB (connected with " clump ")

In certain cases they may be found by direct microscopic examination, especially when they are stained by Gram's method, but it is far more easy to demonstrate their presence by the culture method. On Loeffler's special medium the bacilli flourish so well at body-temperatureabout 370 C.—that, like the cholera bacillus, they outgrow the other organisms present, and may beobtained in comparatively pure culture. Distinct colonies may often be found as early as the eighth or twelfth hour of incubation; in from eighteen to twenty-four hours they appear as rounded, elevated, moderately translucent, greyish white colonies, with a yellow tinge, the surface moist and the margins slightly irregular or scalloped. They are thicker and somewhat more opaque in the centre. When the colonies are few and widely separated, each may grow to a considerable See also:

• SIZE

Behring, going still further, found that the tissues so acclimatized have the power of producing a substance capable of neutralizing the toxin, a substance which, at first confined to the cells, when formed in large quantities overflows into the fluids of the blood, with which it is distributed through-out the body. The bulk of this toxin-neutralizing substance remains in the blood-serum after separation of the clot. In proof of this he showed that (I) if this serum be injected into an animal before it is inoculated with even mere than a lethal dose of the diphtheria bacillus or its products, the animal remains perfectly well; (2) a certain quantity of this serum, mixed with diphtheria toxin and injected into a guinea-pig, gives rise to no ill effects; and (3) that even when injected some hours after the bacillus or its toxins, the serum is still capable of neutralizing the action of these substances. In these experiments we have the germ of the present antitoxic treatment which has so materially diminished the percentage mortality in diphtheria. This serum may also be used as a prophylactic agent. The antitoxic serum as now used is prepared by injecting into the subcutaneous tissues of a horse the products of the diphtheria bacillus. The bacillus, grown in broth containing peptone and blood-serum or blood-plasma, is filtered and heated to a temperature of 68° or 70° C. for one hour. It then contains only a small amount of active toxin, but injected into the horse it renders that animal highly insusceptible to the action of strong diphtheria toxins, and even induces the production of a considerable amount of antitoxin. This production of antitoxin, however, may be accelerated by subsequent repeated injections, with increasing doses of strong diphtheria toxin, which may be so powerful that c to a of a drop, or even less, is a fatal dose for a medium-sized guinea-pig. The anti-toxic serum so prepared may contain 200, 400, 600 or even more " See also:

• UNITS, DIMENSIONS OF
• UNITS, PHYSICAL

In the large hospitals under the See also:

• METROPOLITAN (Lat. metropolitanus, Gr. µnrpoiroXtrns)

First it grows as long, very slender threads, which rapidly break up into shorter sections from 4 to 5 µ in length (see Plate II. fig. 11). In these shorter rods spores may appear on the second or up to the seventh day, according to the temperature at which the growth occurs. The rods then assume a very characteristic See also:

• PIN (a doublet with " pen " from Lat. pinna, feather, pinnacle, which is said to contain the same root as irirvs, pine tree, and properly to mean a sharp point or end)

The most luxuriant growth—evidenced by the longest branches—occurs in the See also:

• DEPTH

As the amount of toxin introduced may be contained in a very small quantity of fluid and still be very dilute, the local reaction of the connective-tissue cells may be exceedingly slight; consequently a very small wound may allow of the introduction of a strong poisonous dose. Many of the cases of so-called idiopathic tetanus are only idiopathic because the wound is trifling in character, and, unless suppuration has taken place, has healed rapidly after .the poison has been introduced. In tetanus, as in diphtheria, the organisms producing the poison, if found in the body at all, are developed only at the seat of inoculation; they do not make their way into the surrounding tissues. In this we have an explanation of the fact that all the earlier experiments with the blood from tetanus patients gave absolutely negative results. It is sometimes stated that the production of tetanus toxin in a wound soon ceases, owing to the See also:

• ARREST (Fr. arrester, arreeter, to stop or stay)

One of the great difficulties met with in the earlier periods of the See also:

• STUD

There is some doubt as to whether tubercle bacilli contain spores, but little masses of deeply-stained protoplasm can be seen, alternating with clear spaces within the sheath; these clear spaces have been held to be spores. This organism is found in the lungs and sputum in various forms of See also:

• CONSUMPTION (Lat. consumere)

If a large dose of this filtered fluid be injected under the skin of a healthy man or See also:

• BRUTE, SIMON WILLIAM GABRIEL (1779–1839)

When small quantities of old tuberculin are injected subcutaneously into a tuberculous patient in whom, however, no tubercle bacilli may be. demonstrable, the temperature begins to rise in six or eight hours and continues to rise for twelve hours or, in rare cases, for an even longer period, a rise of a single degree being considered sufficient to indicate the presenee of the disease. Along with this there is usually some swelling and tenderness, with perhaps redness at the seat of injection, whilst there is also some evidence of a vascular congestion in the neighbourhood of any tuberculous See also:

• LESION (through Fr. from Lat. laesio, injury, laedere, to hurt)

It is evident, therefore, that the careful worker wishing to obtain minimal effects will give small doses and gradually repeat these as he may find necessary. In 1890 Koch, whose brilliant researches on tuberculosis had opened up a new field of investigation and had inspired new See also:

• HOPE, ANTHONY
• HOPE, THOMAS (c. 1770-1831)

This, the so-called " phagocytic power " of Metchnikoff, was found to vary somewhat under different conditions, and Wright set himself to determine, if possible, what were the factors that modified this variability. He found that the white blood corpuscles, the polymorphonuclear cells, whether from healthy or tuberculous patients, always showed practically the same phagocytic activity when mixed with a fine emulsion of tubercle bacilli and the serum from a healthy patient. If, however, corpuscles from the same individuals, whether healthy or tuberculous, were allowed to act upon the bacilli in the presence of serum drawn from a tuberculous patient, one of three things might happen: (i) the bacilli might be taken up in smaller numbers than in the above series of experiments; (2) they might be taken up in larger numbers; or (3) they might be taken up in what might be called normal numbers. In (i) and (2) Wright holds there is evidence of a tuberculous condition, in (3) of course the evidence is negative. He found, however, that when a dose of tuberculin was injected into a tuberculous patient there was a distinct fall in the number of tubercle bacilli taken up by the leucocytes treated with the serum of the patient. This condition Wright speaks of as the " negative phase. ' Increased phagocytic activity of the cells is associated with what is spoken of as the positive phase. The theory is that the blood serum has the power of preparing bacteria to be eaten by the phagocytes in the same sense that boiling, say, prepares food for ready digestion by the human subject, and Wright applied the term opsonin to the unknown constituent or complex of constituents of the serum that exerts this action upon the bacteria. The opsonic index is obtained by comparing the average number of bacilli taken up by, say, See also:

• IOO

If this can be repeated systematically and regularly the patient should begin, and continue, to improve. The difficulties involved in the determination of the opsonic index are, however, exceedingly great, and the personal See also:

• FACTOR (from Lat. facere, to make or do)

Leprosy.—Armauer See also:

• HANSEN, PETER ANDREAS (1795-1874)

What evidence we have at our disposal, however, is all in favour of the transmissibility of the disease from patient to patient and through the agency of the leprosy bacillus. None of the numerous non-bacillary theories of leprosy account at all satisfactorily for this transmissibility of the disease, for its progressive nature, and for the peculiar series of histological changes that are met with in various parts and organs of the leprous body. Leprosy occurs in all climates. It is found where no See also:

• FISH (O. Eng. fist, a word common to Teutonic languages, cf. Dutch visch, Ger. Fisch, Goth. fisks, cognate with the Lat. piscis)
• FISH, HAMILTON (1808-1893)

6). The bacillus is usually straight or slightly curved and rounded at one end; it appears to be non-motile. As first pointed out by Loeffler and Schutz, when a portion of a culture is inoculated subcutaneously, typical farcy, with the acute septicaemia or blood-poisoning so characteristic of certain cases of glanders and farcy, is the result. The human subject is usually inoculated through wounds or scratches, or through the application of the nasal See also:

• DISCHARGE (adapted from the O. Fr. discharge, modern decharge, from a med. Lat. discargare, to unload, dis- and earn care, to load, cf. " charge ")

Dry, it dies in about ten days; placed in distilled water, in about five days; but kept moist, or on culture media, it retains its vitality for about a month, although its activity soon becomes considerably lessened. These bacilli are readily killed at a temperature of 550 C.; they can pass through the kidneys, even when there is no lesion to be made out either with the naked eye or under the microscope (Sherrington and Bonome). The glanders bacillus grows best in the presence of oxygen, but it may grow anaerobically; it then appears to have the power of forming toxin, either more in quantity or of greater activity than when it has access to a free supply of oxygen. This poison (mallein) is used for the purpose of diagnosing the presence of glanders. A cultivation is made in peptonized bouillon to which a small portion of glycerin has been added. The bacillus is allowed to grow and multiply at the temperature of the body for a month or six weeks; the organisms are then killed by heat and 0.5% carbolic acid is added. The cultivation is then filtered through a See also:

• PORCELAIN

II.—To HIGHER VEGETABLE PARASITES Actinomycosis.—This disease is very prevalent in certain low-lying districts, especially amongst cattle, giving rise to the condition known as " sarcoma," " wooden tongue," " wens," " bony growths on the See also:

• JAW (Mid. Eng. jawe, jowe and geowe, O. Eng. cheowan, connected with " chaw " and " chew," and in form with " jowl ")

When once a sinus is formed the diagnosis is easy, but before this the disease, where tumours of considerable size are rapidly formed, may readily be mistaken for sarcoma, or when ' the lungs are affected, for tuberculosis, especially as See also:

• BRONCHITIS

This small body first becomes lobulated, nucleated and pigmented; it then, after assuming a more or less marked rosette-shape ,with a deeply pigmented centre, breaks up into a series of small, rounded, hyaline masses of protoplasm, each of which has a central bright point. The number of these, contained in a kind of capsule, varies from 8 to ro in the quartan, and from r 2 to 20 in the tertian and aestivo-autumnal forms. There are certain differences in the arrangement of the pigment, which is present in larger quantities and distributed over a wider area in the somewhat larger parasites that are found in the tertian and quartan fevers. In the parasite of the aestivo-autumnal fever the pigment is usually found in minute dots, dividing near the See also:

• POLE (FAMILY)
• POLE, REGINALD (1500-1558)
• POLE, RICHARD DE LA (d. 1525)
• POLE, WILLIAM (1814—1900)

The work recently carried out by Bruce on the tsetse-fly parasite, by A. J. See also:

• SMITH
• SMITH, ADAM (1723–1790)
• SMITH, ALEXANDER (183o-1867)
• SMITH, ANDREW JACKSON (1815-1897)
• SMITH, CHARLES EMORY (1842–1908)
• SMITH, CHARLES FERGUSON (1807–1862)
• SMITH, CHARLOTTE (1749-1806)
• SMITH, COLVIN (1795—1875)
• SMITH, EDMUND KIRBY (1824-1893)
• SMITH, G
• SMITH, GEORGE (1789-1846)
• SMITH, GEORGE (184o-1876)
• SMITH, GEORGE ADAM (1856- )
• SMITH, GERRIT (1797–1874)
• SMITH, GOLDWIN (1823-191o)
• SMITH, HENRY BOYNTON (1815-1877)
• SMITH, HENRY JOHN STEPHEN (1826-1883)
• SMITH, HENRY PRESERVED (1847– )
• SMITH, JAMES (1775–1839)
• SMITH, JOHN (1579-1631)
• SMITH, JOHN RAPHAEL (1752–1812)
• SMITH, JOSEPH, JR
• SMITH, MORGAN LEWIS (1822–1874)
• SMITH, RICHARD BAIRD (1818-1861)
• SMITH, ROBERT (1689-1768)
• SMITH, SIR HENRY GEORGE WAKELYN
• SMITH, SIR THOMAS (1513-1577)
• SMITH, SIR WILLIAM (1813-1893)
• SMITH, SIR WILLIAM SIDNEY (1764-1840)
• SMITH, SYDNEY (1771-1845)
• SMITH, THOMAS SOUTHWOOD (1788-1861)
• SMITH, WILLIAM (1769-1839)
• SMITH, WILLIAM (c. 1730-1819)
• SMITH, WILLIAM (fl. 1596)
• SMITH, WILLIAM FARRAR (1824—1903)
• SMITH, WILLIAM HENRY (1808—1872)
• SMITH, WILLIAM HENRY (1825—1891)
• SMITH, WILLIAM ROBERTSON (1846-'894)

Malaria was supposed to be associated Manson, basing his hypothesis upon what he had observed as with watery exhalations and with the fall of dew, but regards the transmission of Filaria by the mosquito, suggested a a wall or a See also:

• ROW, JOHN (c. 1525—1580)

The gametocytes, taken along with the blood into the stomach of this insect, pass through the various phases above mentioned, though the zygote form of the human malarial parasite has not yet been traced. In the blood of a patient bitten by an infected mosquito the ordinary malarial parasite may be demonstrated without any difficulty at the end of a week or ten days, and the cycle recommences. This theory, now no longer a hypothesis, in which the mosquito acts as an intermediary host for one stage of the parasite and transmits the parasite to man, affords an ex-planation of many apparently anomalous conditions associated with the transmission of malaria, whilst it harmonizes with on the other hand, it was supposed to be due to the poisonous exhalations from rocks. All this is now explained by the fact or five days; these contained a number of stationary vacuoles that these are the positions in which mosquitoes occur: wherever and pigment granules, ten to twenty in number, bunched to- I there are stagnant pools, even of a temporary nature, mosgether or distributed in lines. Grassi, Bignami and Bastianelli quitoes may breed. It has been observed that although the confirm and supplement Ross's observations; they find that malarial "miasma" never produces any ill effects in patients Anopheles claviger, taking the blood from a patient suffering living at more than a few feet from the surface of the ground, from malaria, soon develops See also:

• HAEMOSPORIDIA

All these facts afford further support of their way to and accumulate in the cells or tubules of the salivary this theory. The conditions of See also:

• CLIMATE

The See also:

• AMOEBA

When stained by the See also:

• BENDA

Lafleur holds that the amoeba forms a toxic substance which exerts a direct devitalizing effect on the liver cells, and that the amoeba itself causes suppuration. The abscesses in the lung, which invariably extend directly from the liver and occur at the base of the right lung, also contain these amoebae. For these reasons this organism is looked upon as the cause of dysentery and of certain forms of dysenteric abscess. They differ from the Entamoeba coli—often met with in the intestine—which has a more distinct nucleus containing larger chromatin masses and is surrounded by a highly refractile nuclear membrane. Further, in the Entamoeba See also:

• COLL

Syphilis.—It has long been recognized that syphilis is a specific infective disease, but although characterized by fever, anaemia, and increased growths of tissue followed by rapid degeneration and ulceration of tissue, it is only within quite recent years that a definite parasitic organism, present in all cases of typical syphilis, has been isolated and studied. Schaudinn and See also:

• HOFFMANN, AUGUST HEINRICH (1798–1874)
• HOFFMANN, ERNST THEODOR WILHELM (1776-1822)
• HOFFMANN, JOHANN JOSEPH (1805-1878)

Stain for from a quarter to three-quarters of an hour. Wash in running water, blot, dry, and See also:

• MOUNT, WILLIAM SIDNEY (1807-1868)

Again wash in distilled water, dehydrate with alcohol, clear with xylol and See also:

• CEDAR (Lat. cedrus, Gr. iapos)

Leonard See also:

• ROGERS, HENRY DARWIN (18o8—1866)
• ROGERS, JAMES EDWIN THOROLD (1823-1890)
• ROGERS, JOHN (1627–c. 1665)
• ROGERS, JOHN (1829-1904)
• ROGERS, JOHN (c. 1500-1555)
• ROGERS, ROBERT (1727-1784?)
• ROGERS, S
• ROGERS, SAMUEL (1763-1855)
• ROGERS, WILLIAM (1819-1896)

Pour three or four drops of this stain on to the prepared film (blood, bone, marrow, &c.) and run from side to side. After about half a minute add six or eight drops of distilled water, and mix thoroughly by moving the slide or cover-glass. Allow the stain to act for five minutes longer or, if the film be thick, for ten. Wash with distilled water, leaving a drop or two on the glass for about a minute. Examine at once or after drying without heat and mounting in xylol balsam These peculiar parasitic bodies appear as deeply stained points, rounded, oval or See also:

• COCKLE
• COCKLE, SIR JAMES (1819-1395)

Rogers, who succeeded in cultivating them outside the body, described changes which he considers are associated with this latter germ. See also:

• PATTON, FRANCIS LANDEY (1843- )

Sleeping Sickness (Try panosorniasis) .—To the group of diseases caused by See also:

• TRYPANOSOMES, or HAEMOFLAGELLATES

In the centre of the spindle-shaped mass is a very distinct reddish See also:

• PURPLE

It certainly sets up very tardily any changes by which its presence can be detected. The first symptoms of its presence and activity are enlargement of the lymphatic glands, especially those behind the neck, a condition often accompanied by irregular and intermittent fever. After a time, in from three months to three years, according to Bruce, the organism gains access to the fluid in the cerebrospinal canal. Accompanying this latter See also:

• MIGRATION

The enlargement of the spleen appears to go on See also:

• CON

At first the patient is easily aroused from this drowsy condition, but soon he reaches a stage in which he falls sound asleep almost in any attitude and under any conditions, especially after meals. These periods of See also:

• SLEEP (0. Eng. slcepan; Ger. schlafen; cf. Lat. labi, to glide, and " slip ")

The authorities in the plague-stricken areas recommend, therefore, the clearance of belts thirty yards in width along portions of the See also:

• LAKE
• LAKE, GERARD LAKE, 1ST VISCOUNT (1744-1808)

Low, who has demonstrated that the embryos of the filaria may be found in the proboscis of the mosquito (Culex ciliaris), whence they probably find their way into the circulating blood of the human subject. Lt appears that the filaria embryo after being taken, with the blood of the patient, into the stomach of the mosquito, loses its sheath; after which, leaving the stomach, it passes into the thoracic muscles of its intermediate host, and becomes more fully developed, increasing considerably in size and attaining a mouth, an alimentary canal, and the characteristic trilobed caudal appendage. It now leaves the thoracic muscles, and, passing towards the head, makes its way " into the loose cellular tissue which abounds in the prothorax in the neighbourhood ofthe salivary glands." Most of them then " pass along the neck, enter the lower part of the head," whence they may pass into the proboscis. Although it has never been demonstrated that the filaria is directly inoculated into the human subject from the proboscis of the mosquito, it seems impossible to doubt that when the mosquito " strikes," the filaria makes its way into the circulation directly from the proboscis. It is important to note that the mosquito, when fed on See also:

• BANANA

Haemorrhages occur into the cerebral ventricles of the brain, especially in the See also:

• FLOOR (from O. Eng. flor, a word common to many Teutonic languages, cf. Dutch vloer, and Ger. Flur, a field, in the feminine, and a floor, masculine)

They are present in large numbers, even at an early stage of the disease, although they are then so small that they may easily escape detection, so small indeed that they may pass through the pores of a Berkefeld filter, the filtrate in such cases being capable of acting as a rabic virus. In the more chronic cases and in the later stages of the disease the Negri bodies may attain a considerable size and may be easily seen under the microscope. They are from o•5µ to 20µ in diameter—the longer the course of the disease the larger the bodies, these larger forms seldom if ever being met with in specially susceptible animals, which soon succumb to the disease. The Negri bodies may be constricted in the middle, or; if some-what elongated, there may be two or three constrictions which give it the appearance of a See also:

• STRING

This, as in tetanus, is accounted for by the fact that the lymphatics of the nerves are much more directly continuous with the central nervous system than are any other set. of lymphatics. The poison appears to act directly upon the cells of the central nervous system. Arising out of recent researches on hydrophobia, two methods of treatment—one of which, at any rate, has been attended by conspicuous success—have been put into practice. The first of these, Pasteur's, is based upon the fact that rabic virus may be intensified or attenuated at will. Pasteur found that although the virus taken from the cerebrospinal fluid of the dog always produces death in the same period when inoculated into the same animal, virus taken from other animals has not the same activity. If passed through a See also:

• SUCCESSION (Lat. successio, from succedere, to follow after)

At the end of twenty-four hours the activity of the virus is found to have fallen but slightly; at the end of forty-eight hours there is a still further falling off, until on the fourteenth or fifteenth day the virus is no longer lethal. With material so prepared Pasteur treated patients who had been bitten by mad See also:

• DOGS, ISLE OF

As regards the necessity for any treatment it may be pointed out that although the saliva of a rabid dog may be infective three days before the manifestation of any symptoms of the disease death takes place almost invariably within six days of the first symptom. If therefore the animal remains alive for ten days after the patient is bitten, there is no necessity for the antirabic treatment to be applied and the patient need fear no evil results from the bite. There can be little doubt that hydrophobia is a specific disease due to a multiplication of some virus in the nervous system, in the elements of which it is ultimately fixed; that it passes from the wound to the central nervous system by the lymphatics; and that, as in tetanus, the muscular spasms are the result of the action of some special poison on the central nervous system. Scarlet Fever.—In scarlet fever recent observations have been comparatively few and unimportant. creoke, and later See also:

• KLEIN, JULIUS LEOPOLD (1810–1876)

This vaccine organism must be very minute; it is stated that it can be cultivated only on special media, though it multiplies freely in the superficial cutaneous tissues of the calf, the monkey and the human subject. Perhaps the most important outcome of Dr Monckton Copeman's work on this subject is that he has obtained a vaccine lymph from which are eliminated all streptococci and staphylococci, and, if the lymph be taken with reasonable care, any other organisms which could possibly give rise to untoward results. Typhus Fever.—Although it is fully recognized that typhus must be one of the specific infective fevers brought about by the action of a special micro-organism, no definite information as to the bacterial aetiology of this condition has been obtained. It is always looked upon as a " filth " disease; and from the frequency of minute haemorrhages, and from the resemblance to the haemorrhagic septicaemias in other respects, it appears probable that the bacillus of typhus is the organism described by Mott in 1883 as an actively motile dumb-bell coccus, and ten years later by Dubieff and See also:

• BRUHL
• BRUHL, HEINRICH, COUNT VON (1700-1763)

The infectivity continues for some time, probably for nearly a week after naked-eye manifestations of the diseased condition have disappeared. Whooping-Cough.—A diplococcus, a streptococcus, and various higher fungi have in turn been put down as the cause of this disease. It must, from its resemblance to the other specific infective fevers, be considered as an infective disease of microbic origin, which goes through a regular period of incubation and invasion, and in which true nervous lesions, especially of the pneumogastric and See also:

• SUPERIOR

Therapie d. Menschen u. d. Hausthiere (Leipzig, 1898) ; Woodhead, Bacteria and their Products (London, 1891). Actinomycosis: See also:

• BOSTROM, CHRISTOFFER JACOB (1797-1866)

Bd. Health, Mass. (See also:

• BOSTON
• BOSTON, THOMAS (1676-1732)

Med. Journ. ii. 1334 (1908). Cholera: Dunbar, in Lubarsch u. Ostertag's Ergebn. d. allg. Pathologie, vol. i. (1896). Diphtheria: Behring, " Die Geschichte d. Diphtherie " (Leipzig, 1893), and various other papers, principally in Zeits. f. See also:

• HYGIENE (Fr. hygiene, from Gr. ir'taivety, to be healthy)

Grundlagen," Klinisches Jahrb., Bd. vi. (1897); Klebs, " Ueber Diphtherie," Verh. d. II. Congr. f. See also:

• INN

Med. Journ. vol. i. (1892) ; Nuttall and See also:

• GRAHAM, SIR GERALD (1831–1899)
• GRAHAM, SIR JAMES ROBERT GEORGE
• GRAHAM, SYLVESTER (1794-1851)
• GRAHAM, THOMAS (1805-1869)

See also:

• BULL
• BULL, GEORGE (1634–1710)
• BULL, JOHN (c. 1562–1628)
• BULL, OLE BORNEMANN (18ro-188o)

(1900) ; Manson, Tropical Diseases (3rd ed., London, 1903). Gonorrhoea: Bumm, Der Mikro-organismus d. gonorrh. Schleimhaut-Erkrankungen (Wiesbaden, 1885); See, Le Gonocoque (See also:

• PARIS
• PARIS (also called ALEXANDROS)
• PARIS, ALEXIS PAULIN (1800-x881)
• PARIS, BRUNO PAULIN GASTON (1839-1903)
• PARIS, FRANCOIS DE (169o-1727)
• PARIS, LOUIS PHILIPPE ALBERT
• PARIS, TREATIES OF (1814-1815)

Hydrophobia: Babes and Lepp, " Rech. s. 1. vaccination antirabique," See also:

• ANN

Pasteur, t. i. (1887) and t. ii. (1888) ; Tizzoni and Centanni, Lancet, vol. ii. (1895). Influenza: Canon, " Ueber einen Mikro-org. i., Blute v. Influenzakranken," Deutsche med. Wochenschr. (1892); Pfeiffer, " Vorl. Mitth. u. d. Erreger d. Influenza," Deutsche razed. Wochenschr.

(1892). RA1a-Azar: Laveran et Mesnil, See also:

• CORN (a common Teutonic word; cf. Lat. granum, seed, grain)
• CORN (fromm Lat. corms, horn)

Aspects, trans. by N. See also:

• WALKER, FRANCIS AMASA (1840-1897)
• WALKER, FREDERICK (184o--1875)
• WALKER, GEORGE (c. 1618-169o)
• WALKER, HENRY OLIVER (1843— )
• WALKER, HORATIO (1858– )
• WALKER, JOHN (1732—1807)
• WALKER, OBADIAH (1616-1699)
• WALKER, ROBERT (d. c. 1658)
• WALKER, ROBERT JAMES (1801-1869)
• WALKER, SEARS COOK (1805—1853)
• WALKER, THOMAS (1784—1836)
• WALKER, WILLIAM (1824-1860)

Path. Soc. Lond. vol. See also:

• XXIV

Pasteur, t. viii. (1894). Malaria: Celli, Malaria, trans. by See also:

• EYRE, EDWARD JOHN (1815-1901)
• EYRE, SIR JAMES (1734-1799)

(1900), and Journ. Hyg. vols. i., ii. (19oi) ; Nuttall and See also:

• SHIPLEY
• SHIPLEY, JONATHAN (1714-1788)

Journ. vol. i. (1889) ; " Malta Fever," in See also:

• DAVIDSON, ANDREW BRUCE (1831–1902)
• DAVIDSON, JOHN (1857–1909)
• DAVIDSON, RANDALL THOMAS (1848– )
• DAVIDSON, SAMUEL (1807-1898)
• DAVIDSON, THOMAS (1817-1885)

Bd. cix. (1887); Weichselbaum, Fortschritte d. Medicin, Bd. v. (1887). Plague: Bannerman, Journ. Hyg. vi. 179 (1906); and Edin. Med. Journ. n.s., See also:

• XXIII

(1899) ; Calmette et Salimbeni, Ann. de l'inst. Pasteur, xiii. 865 (1899) ; Haffkine, " Further Papers See also:

• RELATING

Med. Journ. ii. 369 (1894) ; Reports on Plague Investigations in India, in Journ. Hyg. vi. 421 (1906), vii. 323, 693 (1907—1908); Simond, Ann. de l'inst. Pasteur, xii. 625 (1898); Yersin, " La Poste bubonique A Hong-Kong," Ann. de l'inst. Pasteur, t. viii. (1894) : also Yersin, Calmette and Borrel, op. cit., t. ix. (1895). Relapsing Fever: Koch, Deutsche med.

Wochenschr. (1879) ; Soudakewitch, " Recherches s. 1. fievre recurrente," Ann. de i'inst. Pasteur, t. v. (1891). Sleeping Sickness: See also:

• BROWNING, ELIZABETH BARRETT (z8o6-r861)
• BROWNING, OSCAR (1837- )
• BROWNING, ROBERT (1812-1889)

Wochenschr. S.S. 233, 280, 310, 341 (1907) ; Laveran and Mensil, Trypanosomes and Trypanosomiases, trans. by Nabarro (London, 1907) ; Royal Society, Reports of the Sleeping Sickness Commission, No. t (London, Aug. 1903 onwards). Suppuration and Septicaemia: See also:

• WATSON, RICHARD (1737-1816)
• WATSON, THOMAS (c. 1557–1592)
• WATSON, WILLIAM (1858- )
• WATSON, WILLIAM (c. 1559-1603)

Pasteur, t. xvu.—xx. (1903—1906); Schaudinn and Hoffmann, Arb. a. d. Kaiserl Gesundheitsamte, xxii. 527 (1905); Berl. See also:

• MIN

S. 745 (1906). Tetanus: Behring, " Die Blutserumtherapie," Zeits. f. Hygiene, Bd. xii. (1892); Knud See also:

• FABER
• FABER (or LEFEVRE), JOHANN (1478-1541)
• FABER, BASIL (1520-c. 1576)
• FABER, FABRI
• FABER, FREDERICK WILLIAM (1814-1863)

(1898); Vaillard, Vaillard and Rouget, Vaillard and Vincent, various articles in the Ann. de l'inst. Pasteur, t. v. (1891), and t. vi. (1892); Wassermann and Takaki, " Ueb. tetanusantitox. Eigenschaften d. normalen Centralnervensystems," Berl. klin. Wochenschr. (1898). Tsetse-fly Disease: Bradford and Plimmer, Proc. Roy. Soc. Lond. lxv. 274 (1899); Bruce, Tsetse-fly Disease or Nagana, in See also:

• ZULULAND

Roy. Soc. Lond. Ixiv. too (1898). Tuberculosis: Bosanquet and Eyre, Serums, Vaccines and Toxines (2nd ed., London, 1909); Calmette, Compt. rend. acad. d. sc. exliv. 1324 (Paris, 1907); See also:

• FORTESCUE, SIR JOHN (c. 1394-c. 1476)
• FORTESCUE, SIR JOHN (c. 1531-1607)

209 (1897); Mitth. a. d. kaiserl. Gesundheitsamte, Bd. ii. (1884); von Pirquet, See also:

• DEUTSCH, IMMANUEL OSCAR MENAHEM (1829-1873)

Roy. Soc. Med. vol. i. (London, 1908), (Epidem. Section), p. 175; Durham, " On a Special Action of the Serum of highly immunized Animals," Journ. Path. and Bact. vol. iv. (1896—1897); Easton, Boston Med. and Surg. Journ. cliii. 195 (1905); See also:

• FORSTER, FRANCOIS (179o-,872)
• FORSTER, FRIEDRICH CHRISTOPH (1791-1868)
• FORSTER, JOHANN GEORG ADAM (1754-1794)
• FORSTER, JOHN (1812-1876)
• FORSTER, JOHN COOPER (1823-1886)
• FORSTER, WILLIAM EDWARD (1818-1886)

1 (1908); Frosch, Kiin. Jahrb. xix. 537 (Jena, 19o8); Max Gruber, " Z. Theorie d. Agglutination," Munch. med. Wochenschr. (1899) ; Grunbaum, Lancet, vol. ii. (1896) Kayser, Arb. a. d. kaiserl. Gesundheitsamte, Bd. 24, S.S. 173, 17b (Berlin, 1906) ; Bd. 25, S.

223 (1907) ; Ledingham and Ledingham, Brit. Med. Journ. i. 15 (London, 19o8); Sanarelli, " Etudes s. I. Fievre typhoide experimentale," Ann. de i'inst. Pasteur, t. vi. (1892), and t. viii. (1894); See also:

• THOMSON, JAMES (1822-1892)
• THOMSON, JAMES (1834-1882)
• THOMSON, JAMES (r700-1748)
• THOMSON, JOHN (1778-184o)
• THOMSON, JOSEPH (1858-1895)
• THOMSON, SIR CHARLES WYVILLE (1830-1882)
• THOMSON, THOMAS (1773-1852)
• THOMSON, WILLIAM (1819-189o)

256; Variola: Calkins, Journ. Med. Research (1904), xi. 136; Councilman, Magrath and Brinckerhoff, Journ. Med. Research (1903), ix. 372, (1904), xi. 12; Guarnieri, See also:

• ARCH
• ARCH, JOSEPH (1826– )

(1894), S. 299: Weil's Disease: Weil, " Ueb. eine eigenthiiml. m. Milztumor, Ikterus . . . akute Infectionskrankheit," Deutsche Arch. f. klin. Med. (1886), Bd. xxxix. Yellow Fever: Beauperthuy, Travaux scientifiques (See also:

• BORDEAUX

Med. Journ. (1901), i. 450. (G. S.