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THE PASSAGE OF SPIROCHÆTA DUTTONI FROM MOTHER TO FŒTUS.
I
KINGHORN: PASSAGE OF SPIROCHATA DUTTONI, ETC.
DIi. BREINL & DR.
on May 18th and although no spirochætæ were seen in the blood preparations made after death a subinoculated rat showed the parasites on the following day. The two fnctusea were about three-quarters mature. Although preparations of their blood were examined carefully no parasites were found but the inoculation of a rat proved positive after a prolonged incubation period of six days and the infection ran its
PASSAGE OF SPIROCHÆTA DUTTONI
THE
FROM MOTHER TO FŒTUS. BY ANTON BREINL,
M.D.,
usual
ASSISTANT LECTURER IN TROPICAL MEDICINE, LIVERPOOL SCHOOL OF TROPICAL MEDICINE ;
JOHNSTON COLONIAL
(From the
FELLOW,
M.B. TORONTO,
UNIVERSITY OF LIVERPOOL.
Runcorn Research Laboratories of the School of Tropical Medicine.)
course.
In order to see whether there exists any inborn immunity two young rats, from four to five weeks old, born while the mothers were heavily infected, were inoculated with blood containing spirochætæ. They showed no immunity but became infected and passed through an attack identical with that observed in normal rats of the same age. On a third rat ticks were fed and the parasites in the peripheral circulation after five days, the usual incubation
AND
ALLAN KINGHORN,
219
Liverpool
appeared
period. Spirochaeta obermeieri Albrecht states The above experiments lead to the following conclusions : that he found the parasites in four foetuses, seven months 1. Spirochæta duttoni passes through the placenta from the old, from mothers who were suffering from European re- circulation of the mother to that of the foetus. 2. The of the foetuses carried by an infected mother are lapsing fever. Spitz made a similar observation in the case majority themselves infected. 3. The parasites are found in the of a five-months’ foetus, finding the parasites in an intrain approximately the same numbers as in the placenta cranial hoemorrhage. In our experimental work on t7’c- maternal heart blood, but, on the contrary, occur in very cllaeta duttoni, the organism of African relapsing fever, owe scanty numbers in the foetal circulation. 4. The spirochætæ I have been able to demonstrate the passage of the parasites in the foetal circulation show no morphological changes. from mother to foatus in the case of four rats and one 5. Infected pregnant rats show no tendency towards abortion, but ftw of their young, in comparison with those guinea-pig. from healthy mothers, reach maturity. 6. The young born Experiment 1082 C.-Rat inoculated on April 3rd, 19G6, with heavily of infected mothers possess no marked inborn immunity infected blood. After showing spirochsetse for 16 consecutive days it was killed for subinoculation. The heart blood showed from 20 to 30 against infection either by means of direct inoculation or parasites to a field (Zeiss 1’r oil immersion, No. 4 ocular). The heart through the bites of ticks. blood of three foetuses and that of their were IN
a
publication
on
I
half-grown
placenta
examined with the following results :Placenta 1., 1 to 2 spiroehsetse per field: Foetus I., 1 spirochaeta to film II., 6,,88 " " " ,, II.,4 spiroch2etw " " III, 1 3 " " " IIL, 1 spirochæta" Film preparations of the brain, bone marrow, and spleen of one foetus were examined. Parasites were found only in the preparations from the spleen. Experirnettt 1084.—Rat inoculated on April 6th. Three days later, when the blood contained innumerable spirochsetee, it was.killed. The foetuses (seven) were nearly mature. The placenta were darker in colour than usual but otherwise presented no macroscopical changes. In blood from the uterine vein the spirochaetae were present in very ,
numbers and in the placental blood they were in such numbers that in the preparation nothing but large bundles of spirochætæ could be seen. In preparations from the umbilical vein one spirochaeta was seen in from 5 to 30 fields. The foetuses showed varying numbers, on an average one to three fields, though in some fields as many as ten spirochætæ could be counted. Experiment 1178 C.-Rat inoculated on May 26th and killed three days later, when the heart blood showed from 70 to 100 parasites to a field. The fcetuses (seven) were nearly mature. The blood in the uterine vein showed about the same number of parasites as the heart
A CASE OF CARDIAC SYPHILOMA WITH BRADYCARDIA AND OBSTRUCTION OF THE INFERIOR VENA CAVA: THE
AFTER-HISTORY AND A POST-MORTEM
BY CHARLES W.
Subinoculations were made from this rat and the fcetuses to ascertain whether the spirochætæ in the fcetal circulation were still infective and as virulent as those in the maternal
blood, Experiment 1182.-Two rats were inoculated from the mother. Both showed many parasites in the peripheral circulation after an incubation period of four hours and passed through the usual course of the infection. Another rat inoculated with three cubic centimetres of citrated heart blood from three of the foetuses showed two spirochsetse in a preparation of the peripheral blood after an incubation period of six hours. No parasites were seen for the next two days, but on the fourth day they were again present and the rat then passed through the ordinary course of infection. Experiment 1238.—Rat inoculated on July 3rd and killed three days later. The heart blood showed from one to two spirochætæ per field. Preparations from the heart blood of ten half-grown foetuses were examined and parasites were found in very scanty numbers (never more than two to a thick film) in eight of these. In the placental blood there were on an average from one to two spirochaetae per field. Experiment 1152.—Pregnant guinea-pig. Inoculated on May 13th and became infected after an incubation period of six hours. It died 1 Breinl and Kinghorn: Observations on the Animal Reactions of the Spirochæta of the African Tick Fever, THE LANCET, March 10th,
1906, p. 668.
CHAPMAN, M.D. DURH.,
M.R.C.P. LOND. SENIOR PHYSICIAN TO THE NATIONAL HOSPITAL FO
large
blood.
RECORD.1
DISEASES OF THE
HEART, SOHO-SQUARE.
IN the session 1897-98 of this society I showed a man, years, whose case is the subject of this communication, under the heading A Case of Bradycardia with Obstruction of the Inferior Vena Cava." The action of the heart was slow and there was a mitral systolic murmur. There were greatly distended and varicose veins over the middle and right side of the abdomen and a similar condition was seen on the outer side of the right leg. This condition, so far as the abdomen was concerned, had existed for at least five years, while the veins of the leg had only recently become dilated. There was a history of an itching sore on the penis 20 years previously. There had been no secondary symptoms and, as the sore had been of little or no inconvenience to the patient, only a short local treatment had been adopted. During the following session I read a paper on the same case entitled "A Case of Obstruction of the Inferior Vena Cava, probably Sypbilitic." In this paper I went fully into the history of the case and detailed the conditions found A provisional diagnosis was made of on examination. obstruction of the inferior vena cava due to pressure from a gumma or to thrombosis from phlebitis. Arguments in favour of the syphilitic origin of the disease were given together with an account of the treatment adopted, the paper concluding with references to recorded cases of syphilitic affections of the circulatory system and to literature bearing on the subject. The account of the case when exhibited and the report of the paper are to be found in Vols. XXXII. and XXXIII. of the Transactions of the
aged 48
Clinical Society.
Up to May 6th, 1905, the man had been a more or less constant attendant at the out-patient room, which means that I had him under observation for eight years, and that he had had dilated abdominal veins for nearly 14 years. There was nothing special to note beyond that he was for the greater part of the time under iodide of sodium, that the pulse-rate ranged between 33 and 44 to the minute, and that there was an entire absence of syncopal attacks. He was never well 1
A paper read before the Clinical
Society of London.
KINGHORN: PASSAGE OF SPIROCHATA DUTTONI, ETC.
DIi. BREINL & DR.
on May 18th and although no spirochætæ were seen in the blood preparations made after death a subinoculated rat showed the parasites on the following day. The two fnctusea were about three-quarters mature. Although preparations of their blood were examined carefully no parasites were found but the inoculation of a rat proved positive after a prolonged incubation period of six days and the infection ran its
PASSAGE OF SPIROCHÆTA DUTTONI
THE
FROM MOTHER TO FŒTUS. BY ANTON BREINL,
M.D.,
usual
ASSISTANT LECTURER IN TROPICAL MEDICINE, LIVERPOOL SCHOOL OF TROPICAL MEDICINE ;
JOHNSTON COLONIAL
(From the
FELLOW,
M.B. TORONTO,
UNIVERSITY OF LIVERPOOL.
Runcorn Research Laboratories of the School of Tropical Medicine.)
course.
In order to see whether there exists any inborn immunity two young rats, from four to five weeks old, born while the mothers were heavily infected, were inoculated with blood containing spirochætæ. They showed no immunity but became infected and passed through an attack identical with that observed in normal rats of the same age. On a third rat ticks were fed and the parasites in the peripheral circulation after five days, the usual incubation
AND
ALLAN KINGHORN,
219
Liverpool
appeared
period. Spirochaeta obermeieri Albrecht states The above experiments lead to the following conclusions : that he found the parasites in four foetuses, seven months 1. Spirochæta duttoni passes through the placenta from the old, from mothers who were suffering from European re- circulation of the mother to that of the foetus. 2. The of the foetuses carried by an infected mother are lapsing fever. Spitz made a similar observation in the case majority themselves infected. 3. The parasites are found in the of a five-months’ foetus, finding the parasites in an intrain approximately the same numbers as in the placenta cranial hoemorrhage. In our experimental work on t7’c- maternal heart blood, but, on the contrary, occur in very cllaeta duttoni, the organism of African relapsing fever, owe scanty numbers in the foetal circulation. 4. The spirochætæ I have been able to demonstrate the passage of the parasites in the foetal circulation show no morphological changes. from mother to foatus in the case of four rats and one 5. Infected pregnant rats show no tendency towards abortion, but ftw of their young, in comparison with those guinea-pig. from healthy mothers, reach maturity. 6. The young born Experiment 1082 C.-Rat inoculated on April 3rd, 19G6, with heavily of infected mothers possess no marked inborn immunity infected blood. After showing spirochsetse for 16 consecutive days it was killed for subinoculation. The heart blood showed from 20 to 30 against infection either by means of direct inoculation or parasites to a field (Zeiss 1’r oil immersion, No. 4 ocular). The heart through the bites of ticks. blood of three foetuses and that of their were IN
a
publication
on
I
half-grown
placenta
examined with the following results :Placenta 1., 1 to 2 spiroehsetse per field: Foetus I., 1 spirochaeta to film II., 6,,88 " " " ,, II.,4 spiroch2etw " " III, 1 3 " " " IIL, 1 spirochæta" Film preparations of the brain, bone marrow, and spleen of one foetus were examined. Parasites were found only in the preparations from the spleen. Experirnettt 1084.—Rat inoculated on April 6th. Three days later, when the blood contained innumerable spirochsetee, it was.killed. The foetuses (seven) were nearly mature. The placenta were darker in colour than usual but otherwise presented no macroscopical changes. In blood from the uterine vein the spirochaetae were present in very ,
numbers and in the placental blood they were in such numbers that in the preparation nothing but large bundles of spirochætæ could be seen. In preparations from the umbilical vein one spirochaeta was seen in from 5 to 30 fields. The foetuses showed varying numbers, on an average one to three fields, though in some fields as many as ten spirochætæ could be counted. Experiment 1178 C.-Rat inoculated on May 26th and killed three days later, when the heart blood showed from 70 to 100 parasites to a field. The fcetuses (seven) were nearly mature. The blood in the uterine vein showed about the same number of parasites as the heart
A CASE OF CARDIAC SYPHILOMA WITH BRADYCARDIA AND OBSTRUCTION OF THE INFERIOR VENA CAVA: THE
AFTER-HISTORY AND A POST-MORTEM
BY CHARLES W.
Subinoculations were made from this rat and the fcetuses to ascertain whether the spirochætæ in the fcetal circulation were still infective and as virulent as those in the maternal
blood, Experiment 1182.-Two rats were inoculated from the mother. Both showed many parasites in the peripheral circulation after an incubation period of four hours and passed through the usual course of the infection. Another rat inoculated with three cubic centimetres of citrated heart blood from three of the foetuses showed two spirochsetse in a preparation of the peripheral blood after an incubation period of six hours. No parasites were seen for the next two days, but on the fourth day they were again present and the rat then passed through the ordinary course of infection. Experiment 1238.—Rat inoculated on July 3rd and killed three days later. The heart blood showed from one to two spirochætæ per field. Preparations from the heart blood of ten half-grown foetuses were examined and parasites were found in very scanty numbers (never more than two to a thick film) in eight of these. In the placental blood there were on an average from one to two spirochaetae per field. Experiment 1152.—Pregnant guinea-pig. Inoculated on May 13th and became infected after an incubation period of six hours. It died 1 Breinl and Kinghorn: Observations on the Animal Reactions of the Spirochæta of the African Tick Fever, THE LANCET, March 10th,
1906, p. 668.
CHAPMAN, M.D. DURH.,
M.R.C.P. LOND. SENIOR PHYSICIAN TO THE NATIONAL HOSPITAL FO
large
blood.
RECORD.1
DISEASES OF THE
HEART, SOHO-SQUARE.
IN the session 1897-98 of this society I showed a man, years, whose case is the subject of this communication, under the heading A Case of Bradycardia with Obstruction of the Inferior Vena Cava." The action of the heart was slow and there was a mitral systolic murmur. There were greatly distended and varicose veins over the middle and right side of the abdomen and a similar condition was seen on the outer side of the right leg. This condition, so far as the abdomen was concerned, had existed for at least five years, while the veins of the leg had only recently become dilated. There was a history of an itching sore on the penis 20 years previously. There had been no secondary symptoms and, as the sore had been of little or no inconvenience to the patient, only a short local treatment had been adopted. During the following session I read a paper on the same case entitled "A Case of Obstruction of the Inferior Vena Cava, probably Sypbilitic." In this paper I went fully into the history of the case and detailed the conditions found A provisional diagnosis was made of on examination. obstruction of the inferior vena cava due to pressure from a gumma or to thrombosis from phlebitis. Arguments in favour of the syphilitic origin of the disease were given together with an account of the treatment adopted, the paper concluding with references to recorded cases of syphilitic affections of the circulatory system and to literature bearing on the subject. The account of the case when exhibited and the report of the paper are to be found in Vols. XXXII. and XXXIII. of the Transactions of the
aged 48
Clinical Society.
Up to May 6th, 1905, the man had been a more or less constant attendant at the out-patient room, which means that I had him under observation for eight years, and that he had had dilated abdominal veins for nearly 14 years. There was nothing special to note beyond that he was for the greater part of the time under iodide of sodium, that the pulse-rate ranged between 33 and 44 to the minute, and that there was an entire absence of syncopal attacks. He was never well 1
A paper read before the Clinical
Society of London.