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Related post: When you have a serious case of malaria, so
serious that one dose of quinine may be a decid-
ing factor in the treatment, I would suggest that
you try this plan, using the best method you
can work out witl whatever safe material is at
hand, watching the result carefully. I think you
will give another treatment soon afterwards.
THE ORGANISM PROBABLY CAUSING
PELLAGRA.
By T. E. Sanders, M.D.,
Citv Health Officer, Hot Spring.s, Ark.
On July 14, 1914, I withdrew the spinal
fluid from a pellagrin, who had died one hour
previous from a violent case of pellagra, ex-
hibiting Zithromax Cheap Overnight marked cerebral symptoms. I took
all the aseptic precautions that I could. Part
of the fluid I examined and the other part I
inctibated. The part that I examined showed
a very few organisms that appeared to be
oval in shape and the periphery stained more
intenselv than the center with Giemsa stain.
The other part of the spinal fluid was in-
ctibated for about a week before it showed
any apparent growth. I made a smear and
found it to be the same organism. I made a
transfer from the growth in the spinal fluid
to Agar-Bouillon and Loeffler's Blood Serum.
There was no growth on the Agar-Bouillon,
but it grew on the blood serum. T kept the
growth alive on blood serum by transplant-
ing for quite a while then it finally died out.
T did not report it publicly for .•'oar that the
culture might possibly have been " from con-
tamination.
On July 31, 1914, a similar case presented
itself and I went through the same routine and
obtained the same organism. In both cases
the organism finally died out on Loeftler's
blood serum after many transplants.
On October 18, 191 4. I held an autopsy on
a pellagrin, who had died of a violent ty-
])hoidal type of pellagra with marked skin le-
sions of the wet ulcerative type. The abdom-
inal fat was very little, if anv. reduced. The
208
SOUTHERN MEDICAL JOURNAL
spleen was comparatively small to the pella-
grin's weight. I split the spleen with a sterile
knife and inoculated a special media, consist-
ing" of a saturated corn meal and agar bouillon
faintly acid with hydrochloric acid. Upon cul-
turing' I obtained the same organism and it
has been growing- upon that special media ever
since.
The growth upon that media appears as a
grayish white, but a slightly darker shade than
a growth of typhoid bacilli. It does not spread
much on the surface of the media. It is
aerobic and requires a great deal of moisture.
The organism is highly motile and seems to
pass through a definite cycle of some kind.
It is characterized by a multiplicity of forms
changing from a small oval cell-like form to
small bacilli, thread-like bodies, and compara-
tively large bacilli. Most anyone upon first
examination would naturally think that it was
an impure or contaminated culture. Every
day it appears different but appears to come
back to the same forms. I have been growing
it for over four months and the growth ap-
pears the same as when it started. It seems
reasonable that if it was an impure or con-
taminated culture one form would have out-
grown and killed out the other.
After becoming familiar w'ith the different
forms of the organism I began to study a large
number of fecal smears that I had gathered
from pellagrins in the diarrheal stage of the
disease and found that they contained large
quantities of the same organism.
About the first of last December Mr. Har-
vil, a representative of Park Davis Co., re-
quested me to let him send the culture to Z Pak Price Without Insurance the
P. D. Research Laboratory for investigation.
It was sent and they referred it to Dr. Joseph
Goldberger of the U. S. Public Health Service.
Dr. Goldberger wrote mc that he was sending
it back as he was so busy that he did not have
any spare time to make the investigation at
present.
After reading Dr. ?>. \\'. Page's pa])er in
the February issue of the SorriTKRN Med-
ical JouRXAi. I am convinced that we have
both isolated the same organism, although go-
ing at it in different methods.
AUTHORS' ABSTRACTS.
Tropical Diseases and Public Health.
Mosquitoes and Sewerage Disposal. By Frederick
Knab and August Busch, Washington, Can You Get Zithromax Over The Counter D. C.
American Journal of Tropical Diseases and Pre-
ventive Medicine, iNovember, 1914, pp. 333-338.
Certain species of mosquitoes, particularly
Culex pipiens and C. quinquefasciatus, are asso-
ciates of man and multiply most rapidly in the
presence of highly polluted water. The bearing
of this relation on many mosquito outbreaks has
not been sufficiently appreciated. The authors
present a striking case in that of certain suburbs
of one of our large eastern cities, where the install-
ment of contrivances for the sanitary disposal of
sewage brought with it a great mosnuito invasion.
The region is hilly and natural mosquito breeding
places conspicuously absent. Two tanks in which
the sewage is collected for bacterial reduction
were the principal breeding places. In one of
these the number of mosquito egg-rafts found
floating was estimated at 5,000, with an average
of 200 eggs each. Outside of these, mosquitoes
were breeding in lesser numbers in many places,
but in every case the relation to sewage was
obvious. Some small streams were found to con-
tain mosquito larvae wherever they were polluted

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