The Journal of Experimental Medicine

Simonds, J. P.

doi: 10.1084/jem.27.5.539pmid: 19868225

1. In peptone shock there is a marked, precipitate fall in arterial pressure. At the same time there is a fall in venous pressure. 2. In experimental fat embolism, ( a ) the fall in blood pressure is always gradual; ( b ) approximately 1 cc. of oil for each pound of body weight must be injected before a lasting fall in arterial pressure is produced; ( c ) it makes only a slight difference whether this amount is injected in small doses at a time or in relatively large quantities; and ( d ) when the arterial pressure falls, but not till then, the venous pressure rises. 3. In peptone shock, dyspnea, by its suction and force-pump action upon the reservoir of stagnating blood in the liver, brings more blood to the heart and causes a rise in arterial pressure. By repeatedly inducing short periods of dyspnea at frequent intervals, permanently beneficial results are obtained and the life of the animal can be saved. 4. In experimental fat embolism, dyspnea will cause a rise in blood pressure. But permanently beneficial results have not been obtained by this method. If dyspnea is found to bring permanent improvement in surgical shock, it is indirect evidence that this condition is not due to fat embolism. Respiratory suction is probably not responsible for the rise in blood pressure in experimental fat embolism. It seems more likely that the dyspnea in some way facilitates the passage of blood through the embarrassed pulmonary circulation. Artificial respiration with a bellows will also frequently cause a rise in blood pressure in experimental fat embolism. 5. In peptone shock the respiration is usually not affected, although there is some evidence that the respiratory center may be in a state of increased irritability. In experimental fat embolism, in some animals a violent dyspnea develops spontaneously. This is usually accompanied by edema of the lungs. In other instances, an apnea occurs, even before the blood pressure has begun to decline. Footnotes Submitted: 28 November 1917

Goodman, Charles

doi: 10.1084/jem.27.5.563pmid: 19868226

1. Injuries of the abdominal aorta in dogs may be corrected with subsequent perfect restoration of the continuity of the vessel. 2. The complete occlusion of the aorta for a period of 30 minutes is not necessarily followed by serious consequences. 3. In cases in which a portion of the aorta must be resected, an arterial segment taken from another animal can be safely utilized as a transplant. 4. While the reestablishment of the continuity of the severed aorta by the circular suture is possible, the approximation of the severed ends during the suture entails such injury that thrombosis frequently occurs. Therefore, when the aorta is completely severed, the introduction of a transplanted segment is indicated. 5. An arterial tube of increased caliber made of smaller vessels such as the carotid lends itself readily as a transplant to the severed aorta, with a reasonable assurance of reestablishing the continuity of this vessel. 6. Defects in the aorta can be readily corrected by the use of fascial transplants with a minimum danger of thrombosis. Footnotes Submitted: 28 January 1918

Noguchi, Hideyo

doi: 10.1084/jem.27.5.575pmid: 19868227

The present study deals with the morphology and systematic position of the causative agent of infectious jaundice. There are several features which are not found in any of the hitherto known genera of Spirochætoidea which led me to give this organism an independent generic name, Leptospira , denoting the peculiar minute elementary spirals running throughout the body. The absence of a definite terminal flagellum or any flagella, and the remarkable flexibility of the terminal or caudal portion of the organism are other distinguishing features. Unlike all other so called spirochetes the present organism resists the destructive action of 10 per cent saponin. A detailed comparative study of related genera, including Spirochæta, Saprospira, Cristispira, Spironema , and Treponema , has been given with the view of bringing out more strongly the contrast between them and the new genus. A study has been made to discover whether any differential features exist among the strains of Leptospira icterohæmorrhagiæ derived from the American, Japanese, and European sources, but none has been found. It is hoped that the creation of a new genus may facilitate a more exact morphological description than has hitherto been possible, due to the vague use of the term Spirochæta which indiscriminately covered at least six large genera of spiral organisms. Footnotes Submitted: 27 February 1918

Noguchi, Hideyo

doi: 10.1084/jem.27.5.593pmid: 19868228

1. The presence of suitable animal or human serum is essential for the cultivation of Leptospira icterohæmorrhagiæ . 2. The nutrient value of serum is considerably reduced by heating to 60°C. for 30 minutes and is destroyed by boiling (100°C). Filtration through a Berkefeld filter does not diminish the nutrient value of the serum. 3. The cultural value of different animal sera varies considerably. It is entirely absent from the sera of the rat and the pig. The sera of the rabbit, horse, and goat are better suited for the growth of the organism than those of the guinea pig, sheep, donkey, or calf. Human serum is suitable, but not ascitic fluid. 4. Fresh or heated emulsions of the liver, kidney, heart muscle, or testicle of the normal guinea pig or rabbit have no cultural value for the organism. The same may be said of both the white and yolk of the hen's egg. 5. A luxuriant growth takes place in a medium of Ringer's solution to which more than 10 per cent of normal rabbit serum is added. There is only moderate growth with 5 per cent of serum, and none when less than 2 per cent is present. The use of an undiluted serum offers no advantage over a diluted one, provided the latter contains at least 10 per cent of serum. In the case of certain animal sera dilution seems to make them more suitable for cultivation purposes, owing perhaps to its reduction of their inherent alkalinity. 6. The tonicity of the culture medium has but little influence upon the growth and morphology of the organism. A medium containing distilled water as diluent or one containing 8 per cent sodium chloride seems to give identical results. The viability of the organism was greatest in a medium in which Ringer's solution or isotonic salt solution was used as diluent. 7. The reaction of the medium is an important factor in the cultivation of the organism, which thrives most vigorously in a medium of which the reaction is slightly alkaline, not exceeding that of the serum. If the reaction is neutral, the growth is meager, and the culture is short lived. When the reaction of a medium becomes alkaline by the addition of a small amount of sodium hydroxide, or faintly acid by the addition of a little hydrochloric acid, no growth can take place. 8. Leptospira icterohæmorrhagiæ is an obligatory aerobe. Any hindrance to the access of oxygen constitutes an unfavorable factor in obtaining a culture. 9. The addition of carbohydrates to media has no perceptible effect upon the growth or morphology of the organism. The reaction of the media is not modified by their presence. 10. Leptospira icterohæmorrhagiæ grows at any temperature between 37° and 10°C., the optimum zone being 30–37°C. Growth proceeds more rapidly at 37°C. than at 30° or at 25°, but the cultures remain viable much longer at the latter temperatures. No growth takes place at 42°C. 11. Three different media are described for the cultivation of freshly isolated strains. After prolonged cultivation on these media a strain may be readily cultivated in a serum diluted with Ringer's or isotonic salt solution. Footnotes Submitted: 20 February 1918

Noguchi, Hideyo

doi: 10.1084/jem.27.5.609pmid: 19868229

1. Leptospira icterohæmorrhagiæ is unable to grow in the urine, either with or without the addition of suitable culture ingredients, the acidity of the urine being detrimental to the growth. It survives less than 24 hours, unless the urine is neutralized or slightly alkalized, when the period of survival is somewhat longer. If suitable nutrient ingredients are added to the neutralized or slightly alkalized urine, the organism is able to grow for about 10 days, after which multiplication ceases. 2. Feces from normal or jaundiced persons destroy Leptospira icterohæmorrhagiæ within 24 hours when a rich culture is added and the mixture allowed to stand at 26°C. The addition of blood serum and corpuscles does not prevent the destruction of the organism. Autoclaved specimens and filtrates of unheated feces do not constitute a suitable medium in which to keep the organism alive for any length of time, but the addition of blood corpuscles and serum in adequate quantities renders them fairly satisfactory as media. Under natural conditions Leptospira icterohæmorrhagiæ cast off in the feces cannot survive more than 24 hours. 3. Polluted water, sewage, and soil will not serve to keep Leptospira icterohæmorrhagiæ alive for more than 3 days at the most. When deprived by filtration or autoclaving of their bacteria they become indifferent diluents and may be used to make up a culture medium when mixed with serum and citrate plasma of a suitable animal. Sterilized soil with a neutral reaction, when added to a culture, has an unfavorable effect upon the growth of the organism. 4. Most of the aerobic bacteria found in feces, sewage, soil, and tap water inhibit the growth of Leptospira icterohæmorrhagiæ when inoculated into the same medium. Bacillus fæcalis alkaligenes and many strains of non-hemolytic streptococci caused the least interference, although growth was never so vigorous or lasting in the media in which they were present as in the control media. Certain pathogenic bacteria ( Bacillus typhosus, Bacillus paratyphosus, Bacillus dysenteriæ , pneumococcus) are antagonistic to the growth of the spirochete. 5. Leptospira icterohæmorrhagiæ is highly sensitive to the destructive action of bile, bile salts, and sodium oleate, but resists the action of saponin. In this last respect it differs from many so called spirochetes. The destructive action of these agents is counteracted by blood serum. 6. The larvae and adults of the Culex mosquito, the larvæ of the house-fly and bluebottle fly, wood ticks ( Dermacentor andersoni ), and leeches failed to become carriers of the spirochetes when fed on infected guinea pigs or their organs; that is, they cannot play the part of an intermediary host of Leptospira icterohæmorrhagiæ . Footnotes Submitted: 27 February 1918

Austin, J. Harold; Taylor, Herbert D.

doi: 10.1084/jem.27.5.627pmid: 19868230

1. The fall in chlorine concentration of Dakin's hypochlorite solution is more rapid in contact with necrotic than in contact with normal tissue. 2. The fall in chlorine concentration of chloramine-T solution is very slight when applied to necrotic tissue and is negligible when applied to normal tissue. 3. The action of the hypochlorite solution on tissue results in the separation of particles of necrotic tissue, hair, epithelial scales, coagulated serum, etc., and a gradual digestion of these substances, taking place over a period of at least 17 hours. 4. The fall in the chlorine concentration of the hypochlorite solution is not complete until the particles are completely dissolved. 5. Chloramine-T solution, 2 per cent, has no erosive effect comparable with that exhibited by the hypochlorite solution. 6. Repeated exposures to the three solutions show the hypochlorite solution to be superior in its cleansing ability on necrotic tissue. 7. The hypochlorite solution is much more irritating to normal rabbit skin than chloramine-T solution or the alkaline control solution. 8. Therefore, the irritating effects must be due to the readily available chlorine. Footnotes Submitted: 13 February 1918

Taylor, Herbert D.; Austin, J. Harold

doi: 10.1084/jem.27.5.635pmid: 19868231

1. The substances injected intraperitoneally into mice and guinea pigs arranged in the order of their decreasing toxicity are: eucalyptol and brilliant green; mercurophen; mercuric chloride and chloramine-T; dichloramine-T and proflavine; hychlorite, Dakin's hypochlorite, Javelle water, and magnesium hypochlorite; iodine and phenol. 2. Now that Dakin's bland solvent, chlorcosane, is available as a vehicle for dichloramine-T, eucalyptol should probably be discarded for this purpose because of its much greater toxicity. 3. Inasmuch as experienced surgeons do not approve of the injection of solutions of iodine and phenol into closed cavities, it would seem advisable not to use any of the antiseptics here discussed in this manner inasmuch as all exhibit a greater toxicity for mice and guinea pigs than the two chemicals first named. 4. The method of testing toxicity of antiseptics by subcutaneous injection is not satisfactory because exudation and subsequent sloughing reduce the rate of absorption and make uncertain the amount finally absorbed. Footnotes Submitted: 23 March 1918