In 1912, Nicolle, Blaizot and Conseil,156 working in Tunis and using chiefly an Algerian strain of relapsing fever spirochætes (sometimes called S. berbera), showed by direct experiments that infection by means of the bites of Pediculus vestimenti and P. capitis was untenable. As many as 4,707 infected lice were fed on one man, and 6,515 on another occasion were allowed to bite a man after they had fed on a monkey heavily infected with spirochætes, yet no infection of the man followed. Examination of the lice showed that the spirochætes left the gut soon after they were ingested, and passed into the body cavity, which swarmed with spirochætes. The contents of the alimentary tract and the fæces of the lice alike were uninfective. The spirochætes did not reappear in the gut till eight days after an infective feed, but some persisted as late as the nineteenth day when kept at 28° C.

It was noted that the irritation due to the lice caused scratching, and that thereby lice became crushed on to the skin. An emulsion was made of two infected lice and rubbed on to the slightly excoriated skin of one of the above workers. Infection followed five days later. A drop of emulsion placed on the conjunctiva of the human eye produced spirochætosis after an incubation of seven days. The body contents of such lice, then, produce infection when they reach the blood by any excoriated or penetrable surface. The stages leading up to infection in nature briefly are: The irritation due to the louse bites causes scratching, and the lice are crushed on to the skin. The slight abrasion is quite sufficient to permit the entry of the parasite. The louse bite alone is harmless. Infection by way of the eye is quite probable in Africa, remembering the constant trouble due to sand, dust, insects, etc., resulting in frequent touching of the eyes.

The spirochætes occur in the body fluid of the lice and can pass in it to the adjacent organs. Thus they probably find their way into the genital organs, and into the eggs of the lice. Eggs laid twenty to thirty days after the parent became infected have retained the infection, and the larvæ issuing from such eggs must have contained some form of spirochætes, for an emulsion of either the eggs or the larvæ produced spirochætosis when inoculated into monkeys. Further details regarding the spirochætosis in the eggs of the lice and in the larvæ are needed. Hereditary infection, however, has been demonstrated, but is not very common. Sergent and Foley (1914) state that the spirochæte possesses a very small and virulent form which it assumes during apyrexial periods in man and during a period following an infecting meal in the louse. Nicolle and Blanc (1914) find that the organisms are infective in the louse just before they reappear as spirochætes. Nicolle and Blaizot found that female lice were more susceptible to spirochætes than males, four times as many females as males being infected.

Multiplication of S. recurrentis is by longitudinal and transverse division (including so-called “incurvation”), and the organism forms small, ovoid bodies (“coccoid” bodies) in the same way as S. duttoni.

S. recurrentis is the cause of European relapsing fever, and a number of possible varieties of it are associated with relapsing fevers in other parts of the world. Such spirochætes only differ by biological reactions, such as acquired immunity tests. They include:—

S. rossii, the agent of East African relapsing fever; S. novyi, the agent of North American relapsing fever; S. carteri, the agent of Indian relapsing fever; S. berbera, the agent of North African and Egyptian relapsing fever.

Other Human Spirochætes are:—

S. schaudinni. This organism, according to Prowazek, is the agent of ulcus tropicum. It varies in length from 10 µ to 20 µ.

S. aboriginalis has been found in cases of granuloma inguinale in British New Guinea and Western Australia. It also occurs in dogs, and may not be truly parasitic.

S. vincenti. This spirochæte is 12 µ to 25 µ in length, tapers at both ends and has few coils. It has been associated with angina vincenti. It often occurs in company with fusiform bacilli.

S. bronchialis, found by Castellani in 1907 in cases of bronchitis in Ceylon. The parasites are delicate, but show morphological variation. This organism is important and has since been found in the West Indies, India, Philippine Islands and various parts of Africa, such as the Anglo-Egyptian Sudan, Uganda and West Africa. It has recently been the subject of research by Chalmers and O’Farrell, Taylor, and Fantham.

S. phagedenis was found by Noguchi in a ten days old ulcerated swelling of the labium. The organism shows much variation in size, being 4 µ to 30 µ in length.

S. refringens (Schaudinn, 1905) occurs in association with Treponema pallidum in syphilitic lesions, but is non-pathogenic. It is 20 µ to 35 µ long and 0·5 µ to 0·75 µ broad, being larger than T. pallidum and more easily stained.

Various spirochætes have also been notified in vomits, chiefly in Australia; others from the human intestinal tract, e.g., S. eurygyrata; S. stenogyrata (Werner); S. hachaizæ (Kowalski), in cholera motions; S. buccalis (Cohn, 1875) and S. dentium occurring in the human mouth and in carious teeth (S. dentium, Koch, 1877, being the smaller); S. acuminata and S. obtusa found by Castellani in open sores in cases of yaws.

Animal spirochætes of economic importance include:—

S. anserina, highly pathogenic to geese.

S. gallinarum (= S. marchouxi) in fowls. (See p. 119.)

S. theileri in cattle and S. ovina in sheep also occur in Africa; their pathogenicity is not clear.

S. laverani (= S. muris), occurring in the blood of and pathogenic to mice, is probably the smallest spirochæte from the blood, being only 3 µ to 6 µ long.

Numerous spirochætes have been recorded from the guts of various mammals, birds, fishes, amphibia and insects.

Cultivation of Spirochætes.—Cultures of spirochætes have been made with little success or with great difficulty until comparatively recently, when Noguchi (1912) devised a means whereby he has cultivated most of the pathogenic spirochætes as well as some Treponemata.

Noguchi has now cultivated S. duttoni, S. recurrentis, S. rossii, S. novyi and S. gallinarum from the blood; S. phagedenis157 from human phagedænic lesions; S. refringens158 and spirochætes from the teeth.

His method is as follows:—

A piece of fresh, sterile tissue, usually rabbit kidney, is placed in a sterile test-tube. A few drops of citrated blood from the heart of an infected animal, e.g., rat or mouse, is added, and about 15 c.c. of sterile ascitic or hydrocœle fluid is poured quickly into the tube. Some of the tubes are covered with a layer of sterile paraffin oil, others are left uncovered. The tubes are incubated at 37° C. The best results are obtained if the blood is taken from an animal forty-eight to seventy-two hours after it has been inoculated, that is, before the spirochætes reach their maximum multiplicative period in the blood. The presence of some oxygen seems indispensable for these blood spirochætes, and they fail to develop in vacuo or in an atmosphere of hydrogen.

For subcultures, 0·5 c.c. of a culture is added to the medium instead of citrated blood, and it is useful to add a little fresh, normal blood, either human or from an animal, such as a rat.

Noguchi found that the events in cultures were:—

S. duttoni,159 maximum multiplication on the eighth to ninth day; disintegration beginning on the tenth day, spirochætes disappeared after about the fifteenth day. No diminution of virulence was found at the ninth day.

S. rossii (= S. kochi).160 Maximum development on the ninth day, after which the virulence diminishes. The incubation period is also prolonged.

S. recurrentis161 (= S. obermeieri). Maximum growth on the seventh day.

S. novyi.162—Maximum development on the seventh day. It is more difficult to grow than the preceding forms.

All the above spirochætes showed undoubted longitudinal division and transverse division was observed in part.

S. gallinarum163 can be cultivated as above, but transverse division was usual here. Maximum growth occurred in the culture about the fifth day.

Treponemata.

The genus Treponema (Schaudinn, 1905), includes minute, thread-like organisms, with spirally coiled bodies, the spirals being preformed or fixed. No membrane or crista is present, according to Schaudinn, though a slight one is said by Blanchard to be present in the organism of yaws. The ends of the organisms are tapering and pointed. Multiplication is by longitudinal and transverse division. The most important members of the genus are T. pallidum, the agent of syphilis, and T. pertenue, which is responsible for frambœsia or yaws.

Treponema pallidum, Schaudinn, 1905.

Syn.: Spirochæta pallida.

Treponema pallidum was first described by Schaudinn and Hoffmann in 1905 under the name of Spirochæta pallida. It has also been described under the names of Spironema pallida, Microspironema pallida and Trypanosoma luis. Siegel in 1905 described an organism which he called Cytorhyctes luis and considered to be the agent of syphilis. Schaudinn reinvestigated Siegel’s work and found T. pallidum, which he considered to be the causal agent of the disease, and pronounced against Cytorhyctes luis. It is probable now that both workers were correct, for Balfour (1911) has seen the emission of minute granules or “coccoid” bodies from T. pallidum and these granules probably correspond to the C. luis of Siegel. Recently E. H. Ross, having observed a spirochæte stage in the development of Kurloff bodies, thinks that T. pallidum is a stage in the life-history of a Lymphocytozoon. MacDonagh has also described a complicated and somewhat similar cycle, but these observations require further study and confirmation.

T. pallidum varies from 4 µ to 10 µ in length, its average length being 7 µ, while its width is usually about 0·25 µ. Longer individuals of 16 µ to 20 µ have been recorded. The body has from eight to ten spiral turns and forms a tapering process at each end (fig. 56). The organism is most difficult to stain, and its internal structure is little known. It is possibly like that of Spirochæta duttoni or S. balbianii, as the “granule shedding” observed by Balfour is strongly suggestive of the formation of resistant bodies by those spirochætes. Hoffmann (1912) has seen the formation of spores in T. pallidum.

The Treponemata occur in the primary and secondary sores, but are difficult to find in the tertiary eruptions of syphilis. Noguchi and Moore (1913) and Mott164 (1913) have demonstrated T. pallidum in the brain in cases of general paralysis of the insane. Marie and Levaditi (1914), however, consider that the treponeme found in the brain in such cases is different from T. pallidum.

Cultivation of T. pallidum.—This has been accomplished successfully by Noguchi,165 using a modification of his method for spirochæte cultivation, for T. pallidum is much more difficult to grow than spirochætes, being a strict anaerobe.

A piece of fresh, sterile rabbit’s kidney is placed in the lower tube, which is filled with ascitic fluid, or ascitic fluid and bouillon mixture. The tube is inoculated with syphilitic material and corked by inserting the upper tube. In the bottom of the upper tube a piece of sterile rabbit’s kidney is placed and syphilitic material poured over it. A mixture of one part ascitic fluid and two parts of slightly alkaline agar is then poured over the tissue and allowed to solidify. When solid, a layer of sterile paraffin oil is poured on top of it, and the top plugged with cotton wool (fig. 57). The whole is then incubated at 37° C. for two or three weeks. The tissue removes traces of oxygen from the lower levels of the medium and also probably provides a special form of nourishment. At first T. pallidum grows in the solid medium, and then when the cultural conditions in the lower fluid portion become favourable, the organisms migrate thither and multiply abundantly. At first the culture is impure, but after several transferences a pure culture is obtained readily.

The syphilitic material for culture is prepared by cutting off pieces of tissue from the lesions, washing in sterile salt solution containing 1 per cent. sodium citrate, and then emulsifying the tissue in a mortar with sodium citrate.

Good cultures show rapid multiplication, which is invariably by longitudinal division.

In his various cultivation experiments Noguchi166 found morphological and pathogenic variations in T. pallidum. Three forms of the organism were found, namely, thicker, average and thinner types. The lesions caused in the testicle of the rabbit differ according to the variety inoculated, but more work is necessary on the subject.

Noguchi167 has cultivated a separate organism, T. calligyrum, from the surface of human genital or anal lesions, either syphilitic or non-syphilitic. It is apparently non-pathogenic, and is 6 µ to 14 µ long.

Hata (1913)168 has modified the Noguchi technique for the cultivation of spirochætes and treponemes, with a view to simplification and convenience. Hata substitutes normal horse serum for ascitic fluid and the “buffy coat” of the clot of horse blood in place of the small pieces of rabbit’s kidney. It is unnecessary to place sterile paraffin on the surface of the medium.

The horse serum is mixed with twice its volume of physiological saline solution. The mixture is placed in tubes which are heated on a water-bath at 58° C., the temperature being raised gradually until it reaches 70° or 71° C. in three hours. The tubes are then heated at 71° C. for half an hour. After cooling, the contents will consist of an opaque semi-coagulated mass. This semi-coagulated serum and saline mixture may be substituted for Noguchi’s ascitic fluid.

The buff coagulum is cut into small pieces, about 1 c.c. in volume. They must be forced with a sterile glass rod to the bottom of the semi-coagulated serum and saline mixture. The medium is inoculated with a small quantity of infected blood and kept at 37° C. In the case of S. recurrentis, growth of spirochætes is observed on the second day, reaching a maximum in five to seven days. The growth of the organisms proceeds rather more slowly, they live for a longer period and maintain their virulence better than in Noguchi’s medium.

Treponema pertenue, Castellani, 1905.

Syn.: Spirochæta pertenuis; S. pallidula, Castellani, 1905.

Castellani discovered the organism in 1905, in scrapings of yaws pustules. He first described it under the name of Spirochæta pertenuis.

Castellani and others have shown that monkeys successfully inoculated with syphilis do not become immune to yaws, and vice-versâ.

Craig and Ashburn, using the monkey Cynomolgus philippinensis, found these animals susceptible to yaws but not to syphilis.

The ulcerated lesions of frambœsia are rapidly invaded by numerous bacteria as well as by different spirochætes, of which Castellani has described three distinct species. One is identical with Spirochæta refringens, Schaudinn, the other two are thin and delicate. One, S. obtusa, has blunt ends; the other S. acuminata, has pointed ends. T. pertenue is also present.

The reasons for considering T. pertenue to be the specific cause of frambœsia are:—

(1) T. pertenue is the only organism present in non-ulcerated papules, in the spleen and in the lymphatics of yaws patients, or of monkeys artificially infected with the disease. By no method has any other organism been obtained.

(2) Extract of frambœsia material, free from all organisms other than T. pertenue, reproduces the disease if inoculated.

(3) Extract of frambœsia material deprived by filtration of T. pertenue is no longer infective on inoculation.

The method of infection is contaminative, by direct contact. Women in Ceylon are frequently infected by their children. Any slight skin abrasion is sufficient to admit the parasite. In some cases, insects may carry the disease from person to person, and even in hospitals, when dressings are removed, it has been noticed that flies greedily suck the secretion from the ulcers. T. pertenue has been recovered from flies that have fed on yaws, and monkeys have contracted the disease when flies were placed and retained on them for a short time, after the insects had fed on yaws material.

Cultivation.—T. pertenue has been cultivated by Noguchi, who finds three types of parasites in his cultures, as before mentioned. Its multiplication is by longitudinal division.

Noguchi169 (1912), has cultivated species of Treponema from the human mouth, e.g., T. macrodentium, T. microdentium and T. mucosum, the latter from pyorrhea alveolaris. These parasites in the past may have been confused under the name Spirochæta dentium.

Class III. SPOROZOA, Leuckart, 1879.

The third group of the Protozoa consists entirely of parasitic organisms forming the class known as the Sporozoa or spore-producing animals. The members of this class are characterized by possessing very great powers of multiplication, coupled with a capacity for producing forms that serve for the transference of the organisms to other hosts. These reproductive bodies, whether for increase of numbers within one host or for transmission to another host, are called spores. But, strictly, the term spore should be used only in the latter connection, when a protective or resistant coat known as a sporocyst envelops the body of the spore.

The Sporozoa are widely distributed, occurring in various tissues and organs of Annelids, Molluscs, Arthropods, and Vertebrates. Their food, which is fluid, is absorbed osmotically. The life-cycle of a Sporozoön may be completed within one host or may be distributed between two different hosts.

The Sporozoa were divided by Schaudinn into two groups or sub-classes, called (1) the Telosporidia, and (2) the Neosporidia.

The Telosporidia are Sporozoa in which the reproductive phase of the parasites is distinct from the growing or trophic phase, and follows after it. The Neosporidia include Sporozoa in which growth and spore-formation go on simultaneously. This classification is not final, for certain exceptions and difficulties are already known with regard to it. It is possible that the class Sporozoa is not a natural entity, but should be replaced by two classes of equal rank, corresponding in most respects with the Telosporidia and Neosporidia.

The Telosporidia comprise the Gregarinida, the Coccidiidea, and the Hæmosporidia. Doflein combines the two latter orders into one known as the Coccidiomorpha.

The Neosporidia comprise the Myxosporidia, the Microsporidia, the Actinomyxidia, the Sarcosporidia, and the Haplosporidia. Doflein combines the first three orders into one, the Cnidosporidia.

Sub-Class. TELOSPORIDIA, Schaudinn.

Sporozoa in which the reproductive phases follow completion of growth.

Order. Gregarinida, Aimé Schneider emend. Doflein.

The Gregarines are usually elongate, somewhat flattened organisms (figs. 59, 60), whose bodies are enclosed in an elastic and often thick cuticle. The enclosed living substance shows a separation into ectoplasm and endoplasm, as is common among Protozoa. The cuticle is sometimes regarded as the outer portion or epicyte of the ectoplasm. A single, vesicular, spherical, or elliptical, large nucleus, with its chromatin concentrated to form a spherical karyosome, is present. The body of some gregarines may be divided by ingrowing ectoplasmic partitions or septa, and are then said to be “septate” or “polycystid” (fig. 61). Other gregarines remain simple and non-septate, and are termed “monocystid” (fig. 59). The monocystid gregarines occur especially in the body cavity of Chætopoda and Insecta, more rarely in Echinodermata, in the parenchyma of Platyhelminthes, also in the gut of Tunicata and Insecta (fig. 60) and in the seminal vesicles of Annelida. In the polycystid gregarines a single septum only is present as a rule, and thus the body presents two portions: (1) an anterior portion termed the protomerite; (2) a posterior, larger portion, known as the deutomerite, which generally contains the nucleus. The protomerite is often modified anteriorly to form an organ of attachment, termed the epimerite (fig. 61), which is developed from the pointed rostrum of the sporozoite or primary infecting young gregarine. The structure of the epimerite may be complicated, being provided with hooks, spines, knobs, and other appendages. An extension of the polycystid condition is seen in Tæniocystis mira Léger (from the dipteran larva, Ceratopogon solstitialis), whose body shows a number of partitions, giving the organism a superficial resemblance to a tapeworm.

The ectoplasm of a gregarine exhibits three layers: (1) An epicyte (cuticle) externally of which the epimerite is composed; (2) a sarcocyte which forms the septa if present; (3) the deeper myocyte layer containing contractile elements in the form of fibrils or threads termed myonemes (fig. 62).

Many gregarines are capable of active movements, though they do not possess obvious locomotor organs. The movement is of a smooth, gliding character and two suggestions have been put forward to explain it. According to Schewiakoff, a gelatinous substance is secreted between the layers of the ectoplasm. This is extruded posteriorly and thus the animal is pushed forward. On the other hand, Crawley considers that the movements are produced by contractions of the myonemes. These two explanations are probably correct as far as each goes, and are to be regarded as supplementary to one another.

Occasionally, temporary associations of gregarines are formed by a number of individuals adhering to one another end to end. Such temporary associations are examples of syzygy. Such syzygies must not be confused with true associations which form an essential part of the life-cycle.

The life-cycle of a relatively simple gregarine, such as Monocystis agilis (fig. 59), parasitic in earthworms, may now be considered. The gregarines, being members of the Sporozoa, produce spores at one phase of the life-cycle. Each gregarine spore (fig. 63) develops within itself a number of minute, sickle-shaped or vermicular bodies, known as sporozoites or primary infecting germs. Eight sporozoites are often formed within each spore. When absorbed by a new host, the spore softens and the sporozoites issue from it. They are capable of active movement and may or may not enter a cell, such as one of those of the digestive tract, or, as in Monocystis, a cell lining the vesicula seminalis which becomes a sperm-cell aggregate (sperm morula). When the sporozoite has reached the place of its choice in the host it ceases active movements and proceeds to feed passively on the fluid substances around it, whether they be those of tissues or body fluids. This passive, growing and feeding form is known as the trophozoite. After a trophic existence of longer or shorter duration, the trophozoite ceases to feed and prepares for reproduction. Two trophozoites associate together, each of them first becoming somewhat rounded. The two trophozoites, now known as sporonts or gametocytes, become invested in a single common envelope or cyst (fig. 64, a). The nucleus of each gametocyte then divides by a series of binary fissions (fig. 64, b), and the daughter nuclei thus produced arrange themselves at the periphery of the parent cells (fig. 64, c). Cytoplasm collects around each of these nuclei, and thus a number of gametes are formed within each gametocyte. The gametes for a time exhibit active movements, and ultimately ripe gametes of different parentage fuse in pairs, that is, conjugation occurs (fig. 64, d). In this way zygotes are produced, the nucleus of each zygote being formed by the fusion of two gamete nuclei.

The zygote grows slightly and becomes oval or elongate, and at this period is often called the sporoblast. It then secretes an external membrane, the sporocyst. Nuclear division occurs inside the sporocyst by a series of three binary fissions (fig. 64, e), so that each sporocyst, now usually referred to as a spore, contains eight nuclei. The cytoplasm collects around each nucleus and eight vermicular sporozoites are produced within each spore (fig. 64, f), thus completing the life-cycle.

It will be noticed that in the above life-cycle no asexual multiplication occurs. These organisms, such as Monocystis, are known as the Eugregarines, and include the majority of the gregarines. The remainder, which have introduced schizogony into their life-cycle, are known as the Schizogregarines.

Tribe 1.—Acephalina.—Without an epimerite and non-septate; often “cœlomic” (body-cavity) parasites. E.g.: Monocystis, with several species parasitic in the seminal vesicles of earthworms. Many other genera parasitic in Echinodermata, Tunicata, Arthropoda, etc.

Tribe 2.—Cephalina.—With an epimerite, either temporarily or permanently, in the trophic phase. Usually septate (except Doliocystidæ). Many families, genera and species. Common in the digestive tracts of insects. E.g.: Gregarina, with several species, Gregarina ovata in the earwig, Gregarina blattarum in the cockroach, Stylorhynchus in beetles, Pterocephalus in centipedes, etc.

Sub-order II.—Schizogregarinea, with schizogony.

Tribe 1.—Endoschiza.170—With schizogony occurring in the intracellular phase, e.g., Selenidium (from Annelida and Gephyrea), Merogregarina (from an Ascidian).

Tribe 2.—Ectoschiza.—In which the schizont is free, and schizogony is extracellular, e.g., Ophryocystis (from Blaps, a beetle), and Schizocystis (from Ceratopogon larva).

Occurrence.—The Coccidiidea in their mature condition usually live within the epithelial cells of various organs, and by choice inhabit those of the intestine and of its associated organs. They also occur frequently in the excretory organs of mammals, birds, amphibia, molluscs, arthropods, and may also be found in the testes and vas deferens, but the statement that they live in hen’s eggs, as well as in the oviducts of fowls, has not been confirmed.171 Some species inhabit the nuclei of cells, others live in the connective tissue, but their presence in the latter situation is probably only secondary, that is, they have only reached it from the epithelium of the affected organs.

The size of the Coccidiidea, corresponding as a rule to the capacity of their habitat, is usually small, but there are said to be species that attain a diameter of 1 mm. Their form172 is globular, oval, or elliptical. External appendages are lacking, at least during the trophic or vegetative period of their life, which is spent in epithelial cells, within which they increase in size. Frequently one only is present in each cell, but more can occur. The body substance is composed of a more or less finely granular or distinctly alveolar protoplasm which exhibits no differentiation into ecto- and endoplasm. All species possess a nucleus that enlarges with their growth; sometimes it only shows through the cytoplasm as a lighter spot, or may even be quite concealed. It is vesicular, and besides containing very delicate threads of chromatin in the clear nucleoplasm, it contains generally only one large karyosome.

The infected epithelial cells degenerate sooner or later as the parasite feeds on them (fig. 67, II-IV). After their form has been changed by the action of the growing parasite, they finally perish. The cell membrane then alone surrounds the coccidia, which, at least in the species sufficiently known, begin to propagate by an asexual process (schizogony), the parasites themselves becoming schizonts, as the initial stage is usually called. They differ from later stages (sporonts or gametocytes), which resemble them in form, by the absence of granulations in the cytoplasm, as well as by the vesicular nucleus. The form is not always the same, for in some cases, at least, many schizonts assume a globular form.

Schizogony (fig. 67, V-VII) commences with a division of the nucleus, which takes place in different ways in the various species. This finally leads to the formation of numerous daughter nuclei which become smaller and smaller, and which collect beneath the surface of the schizonts. In some species the daughter nuclei collect only in one half of the schizont. A part of the protoplasm of the periphery now divides around each daughter nucleus, the remaining part (residual body) being left in the centre or on one side. The segments of the divided cytoplasm, each containing a nucleus, assume a fusiform shape and become merozoites, which very soon become free (fig. 67, VIII) and leave the residual body. They are distinguishable from the very similar sporozoites (fig. 67, I), as the merozoites possess a karyosome.