Note on the Etiology of Verruga as Deduced from a Study of the Asexual Stages of Bartonella

Abstract

Dec. 4, 1915, the writer presented before the Biological Society of Washington a paper on the identification of the asexual stages of Bacrtonella bacilliformis, the causative organism of verruga, which was published in the Dec. 19, 1915, issue of the Journal of the Washington Academy of Sciences. Jan. 7, 1916, he presented the same subject before Section VIII of the Second Pan-American Scientific Congress, during which presentation he announced certain points additional to those previously announced. This second paper will be published in due course in the Proceedings of the Congress, but it is desirable to place on record at once the additional points announced therein. They are as follows, and should be added to the paper published Dec. 19, 1915: The toxin resulting from the extensive asexual multiplication of Bartonella in the vascular endothelial cells of the subcutaneous tissues is liberated in quantity into the blood, causing the rise of temperature which marks the fever stage of verruga, the anemia following through hemolysis. The proliferation of vascular endothelial cells incited by this toxin not only imprisons the toxin itself, thus arresting the hemolysis, but also prevents the erythrocytes from coming into direct contact with endothelial cells containing merozoites of Bartonella, thus cutting short the infection of the erythrocytes. As the natural result, the fever and anemia both subside, and the gametes of Bartonella are no longer to be found in the peripheral blood. The infected endothelial cell, in situ in the capillary wall, is positively chemotropic for uninfected freshly oxygenated erythrocytes, attracting and holding them in contact with itself until transfer of a certain number of merozoites of Bartonella has been effected, the presence of which reduces the oxygen tension in the substance of the erythrocytes, thereby transforming their tropic qualities, the sufficiently infected erythrocytes being set free through negative chemotropism. The localized proliferation of vascular cells following verruga eruption-tissue inoculations is not due to any new activity of a living organism or virus. The reason why Drs. Strong ct al. were unable to obtain proliferation lesions by injection of a filtrate from these tis-