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THE PHILIPPINE JOURNAL OF SCIENCE f | VOLUME XIV
JANUARY TO JUNE, 1919 WITH 49 PLATES AND 30 TEXT FIGURES
BUREAU OF PRINTING 919 == é
MANILA (> ~
EDITORIAL BOARD ELMER D. MERRILL, M.S., Editor R. C. McGrecor, A.B., Associate Editor
ALBERT H. WELLS, A.B.; J. R. WRIGHT, Pu.D.; A. P. West, PH.D. T. Dar JUAN A.B., PHaR.D.; F. AGcaori, A.B. ; F. D. Reyss, B.S. A. 8. ArGtELLES, B.S.; VicToRIANO ELICANO, B.S.
Chemistry, Physics, and Geology
H. W. Wabg, M.D.; Orro ScHiésu, M.D. F. G. HAuGHWouT; STANTON YOUNGBERG, D.V.M.
Experimental Medicine
Lrpor1o Gomez, M.D., Pu.D.; F.. CALDERON, B.A., L.M. VICENTE DE JESUS, M.D.
Clinical Medicine
W.#H. BRowN, Pu.D.; C. F. BAKER, M.A.; H. S. Yares, M.S., Pu.D. O. A. REINKING, B.S.A., M.S.; L. M. Guerrero, PHar.D.
Botany
E. H. Tayzor, A.B.; R. P. Cowes, Pu.D, C. F. Baker, M.A.; S. F. LicHT, M.A.; C. S. BANKs, M.A. L. D. WHARTON, M.A.; W. SCHULTZE; H. O. BEYER, M.A.
Zoblogy and Ethnology
A. B. BANyEA, Copy Editor
CONTENTS
No. 1, January, 1919 {Issued July 3, 1919.]
Weis, A. H. The physiological active constituents of certain Phil- ippine-medicinal plants +: Wd.25.. secede Bae ce hae aa
One plate. SALEEBY, N. M. The treatment of human beriberi with autolyzed yeast ci 418 2 |] Nae OSE Ae ar Ria eee Peed io tecr t Mores) peya mr eee nope ee espe |
DENNEY, OSWALD E. A photographic study of leprosy. Four plates. LANTIN, Pepro T. A comparative study of different methods of treatment of typhoid fever.......................-...--- ee Ten text figures. . MERRILL, E. D., and WaAprE, H. W. The validity of the name Dis- ' eomyces for the genus of fungi variously called Actinomyces, Streptothrix, and Nocardia
BANKS, CHARLES S. Iontha ida, a new Philippine noctuid One plate.
COCKERELL, T..D. A. The social bees of the Philippine Islands............ CocKERELL, T. D. A. The Philippine bees of the family Nomadidz....
SHuFELDT, R. W. The osteology of the giant gallinule of the Philip- -pines, Porphyrio pulverulentus Temminck: With notes on the osteology of Tachybaptus philippensis (Bonnaterre) and Hydro- phasianus chirurgus (Scopoli)
Five plates.
TAyYLor, Epwarp H. New or rare Philippine reptiles... Two plates and four text figures.
TAYLOR, Epwarp H. Ipon fisheries of Abra River.
REINKING, Otto A. Phytophthora faberi Maubl.: The cause of coco-
nut bud rot in the Philippines......... te ~ ‘Three plates.
Proceedings of the Manila Medical Society.............----------------1--eeeeeee No. 2, February, 1919
[Issued September 5, 1919.]
BANKS, CHARLES S. Phlebotomus nicnic, a new species, the first Phil-
ippine record for this genus One plate.
iii
Page.
13
19
105
127
131
153 155
163
iv Contents .
BANKS, CHARLES S. The bloodsucking insects of the Philippines........
COCKERELL, T. D. A. The Prosopide, or obtuse-tongued bees, of the Pe AUMNNCN a
COCKERELL, T. D. A. The Philippine bees of the families Anthopho- erm ee I
CARREON, MARCIANO. The absence of both hind legs below the femur
Be Cs ge One plate.
HAUGHWOUT, FRANK G., and DE LEON, WALFRIDO. On the ingestion of erythrocytes by Pentatrichomonas sp., found in a case of I a ap ee
One plate.
Wirt, J.C. The effect of calcium sulphate on cement: Second paper.. Two text figures,
PANGANIBAN, C. S., and Scuést, O. Experience with methylena blue- eosin lactose agar in searching for Bacillus dysenteriz in stools...
MERRILL, E. D. Notes on the flora of Sumatra
No. 3, March, 1919 [Issued September 18, 1919.]
Acosta-SIson, Honoria, and CALDERON, FERNANDO. Pelvimetry and cephalometry among Filipino women and newborn babies: Made
on one thousand two hundred thirty-seven cases Five text figures.
AGuitar, R. H. The lumbang-oil industry in the Philippine Islands... Fett, E. P. New Philippine gall midges
ee ie Ao Wen eT Wet EbUE Is TeleediNckEccawka ne cauks
Beccart, O. The palms of the Philippine Islands Three plates.
eg aN een MOE Re et RASA E DWEkNT Sheed bbe Usa: 5d6 ce
No. 4, April, 1919
[Issued September 19, 1919.] MERRILL, E. D. New or noteworthy Philippine plants, XV
No. 5, May, 1919
{I d December 1, 1919.]
ST ae ores Tone Se een eealne sinks SaN ey enw es he deeneen apt chy ia ty
Three text figures.
dyna hevahntctataieitemethete: ta hit Cn ee PN + We wewecccece
Papua, REGINO G. Cystolithiasis among Filipinos in association with dietetic deficiency
One text figure,
SORA RC SE Hane eRe Sth ee ehebsnkbecuk aun
195
201
207
221
235 239 251
253
275 287 295
363
365
459
Contents
Yates, Harry §. The growth of Hevea brasiliensis in the Philippine PERT sti) gpupeee oe cae ree tense hele SPATE UC AGETEN Sipe Sue dear ar "runt ep Ge WAM e Sha Nr Oe TO
One text figure. : UICHANCO, LEOPOLDO B. A sctigleed and systematic study of Phil-
pee to egy Cs k ge «811 aptconaeeere it pent esspencny uberis em ah Mes ery ot) marstise en ne rp Fifteen plates.
COCKERELL, T. D. A. The sphecodine bees of the Philippine Islands....
No. 6, June, 1919
[Issued December 16, 1919.}
Kinc, ALBERT E. W. The mechanical properties of Philippine bast- 1S 90 1, Same ee asa ae sre tort en ele ay orm EP Tremere er oer karen tO” ferret Pee Five plates and two text fais
Lee, H. ATHERTON, and YATES, Harry S. Pink disease of citrus........ Seven plates and two text figures.
ERRATA st a es ES eee en ate eee OE Suid vas cewctn cae
TT a or See eens : Pies
ANNOUNCEMENT
With the beginning of 1919 the sections of the Philippine Journal of Science will be combined, and the publication will be issued as a monthly; each number will be larger than the present bimonthly issues. The policy with regard to the char- acter and scope of the material published will be continued. The Journal is intended to be as it has been, the scientific organ of the Philippine Government, and will be devoted to the scien- tific and commercial interests of the tropics. Its aim will be to collect and publish in one place original scientific informa- tion and material relating to the Philippine Islands. Suitable articles will receive prompt publication in the Philippine Journal of Science, and specialists working on Philippine material will continue to receive hearty codperation.
The subscription price will be 5 dollars United States cur- rency per annum. A refund of 2 dollars will be made to anyone that has forwarded a subscription for the four sections of the Journal at the old rate of 7 dollars. Any sum received as a subscription to a single section. will be credited, and a bill will be rendered for the balance due at the new rate.
The Philippine Journal of Science in its new form will be sent in exchange to all periodicals and institutions with which
exchange relations are in force. THE EDITORS.
MANILA, P. I., December 31, 1918. 162323
THE PHILIPPINE
JOURNAL OF SCIENCE
VoL. XIV JANUARY, 1919 No. 1
THE PHYSIOLOGICAL ACTIVE CONSTITUENTS OF CERTAIN PHILIPPINE MEDICINAL PLANTS: III
By A. H. WELLS (From the Laboratory of Organic Chemistry, Bureau of Science, Manila)
ONE PLATE CONTENTS
ARCANGELISIA FLAVA (LINN.) CASSIA SIAMEA LAM.
Merr. (A. LEMNISCATA BECcc.). GEODORUM NUTANS AMES.
MENISPERMACEAE. CORIARIA INTERMEDIA MATs.
Berberine has been found in the following plants:
Berberis aquifolium. (1) Caulophyllum thalictroides. (14) Jateorhiza palmata. (2) Leontice thalictroides.(15) Hydrastis canadensis. (3) Berberis aetnensis. (16) Menispermum canadense. (4) Cocculus palmatus.(17) Argemone mexicana. (5) Chelidonium majus. (18) Coptis trifolia.(6) Styllaphorum diphyllum.(18) Xanthoxylum americanum. (7) Coscinium fenestratum. (19) Berberis asiatica.(8) Xanthorriza apiifolia. (20) Berberis aristata.(8) Xanthoxylum senegalense. (21) Berberis lycium. (8) Thalictrum flavum. (22) Podophyllum peltatum. (9) Ptelea trifoliata. (23) Berberis vulgaris. (10) Xylopia polycarpa. (24) Coptis tecta.(11) Geoffrayra inermis. (25) Xanthoxylum clava-herculis. Evodia glauca. (26)
(12) Jeffersonia diphylla. (27) Coeloeline polycarpa. (13) Toddalia asiatica. (28)
ARCANGELISIA FLAVA (LINN.) MERR. (A, LEMNISCATA BECC.). MENISPERMACEAE
Philippine names: Albustra, abutra (Ilocano) ; lagtal, lagtan, albotra (Visayan); lagtang, bute, ligtang, suma (Tagalog) ; suma (Pampango).
162323
2 The Philippine Journal of Science 1919
The names albustra, abutra, albotra, and bute are all corrup- ' tions of the Spanish-American name abuta, which was brought from Mexico by the Spaniards. These names are also applied to Anamirta cocculus W. & A. of the same family, which has much smaller fruits and white, not yellow, wood.
It is a coarse, woody vine, the stems up to 10 centimeters in diameter, with a characteristically yellow wood. The species is widely distributed in the Philippines, occurring in most, if not all, of the larger islands and provinces. However, it is local and widely scattered in thickets and forests, occurring especially on rocky slopes. No data as to its abundance were obtainable.
Chemical examination.—The soft porous wood was freed from the thin outer bark, finely ground while fresh, and macerated with 95 per cent ethyl alcohol. The solution resulting from this exhaustion was quickly evaporated under reduced pressure to one-fifth its volume; it was then cooled and salts made with hydrochloric, nitric, sulphuric, and hydriodic acids. A few grams of the pure alkaloid were obtained by an aqueous extrac- tion of portions of the ground wood in a neutralized solution. Repeated extraction and evaporation with alcohol, and final crys- tallization from neutral ethyl acetate in a vacuum desiccator over calcium chloride, gave beautiful golden yellow crystals of the berberine base. When compounds of this ‘nature are crys- tallized in a vacuum desiccator over sulphuric acid it is notice- able that traces of acid sulphates are formed. This was observed particularly when the acetone compound was placed in such a desiccator. The compound was identified as berberine.
Large quantities of salts of the alkaloid were easily crystal- lized out with nitric, sulphuric, and hydrochloric acids. Upon heating, the sulphate melts to a brown amorphous mass, slightly soluble in water; it has an intense yellow color and a bitter taste, is soluble in alcohol and in hot water, and is almost insol- uble in ether and benzene. The solution allows precipitation with alkaloidal reagents and also with potassium iodide solu- tion. In concentrated sulphuric acid it gives an olive green color; a fragment of sodium nitrate added to the sulphuric acid solution gives a characteristic violet color. The acetone com- pound was obtained by the method of acetone treating the sul- phate of the compound in an alcoholic solution. The resultant compound, which is represented as C,,H,,NO,: C,H,O, was also obtained by treating & hot solution of 50 grams of the crystalline berberine sulphate in 1 liter of water. Five hundred grams
eg
pag
{ ~~
XIV, 1 Wells: Philippine Medicinal Plants: III 3
of acetone were added to this solution; after mixing, it was made alkaline with sodium hydroxide. This is a method of Gaze.(29) A greenish yellow crystalline substance separates therefrom (see Plate I). The pure crystalline berberine ob- tained by the decomposition of the berberine acetone compound is dark golden brown, but it is slightly lightened in color by purification with alcohol.
Quantitative determinations made on the plant substance show approximately 4.8 per cent of pure alkaloid in the moisture- free material.
Combustion of the alkaloid, when freed from as much water of crystallization as is possible without apparent decomposition, gave the following results:
Determination No. 1.—0.15 gram of substance gave 0.0788 gram of water and 0.3876 gram of carbon dioxide.
Determination No. 2.—0.15 gram of substance gave 0.0771 gram of water and 0.3854 gram of carbon dioxide.
Theoretically, the combustion of water-free berberine gives carbon 71.64 per cent and hydrogen 5.07 per cent. Determina- tion No. 1 shows carbon 70.47 per cent and hydrogen 5.84 per cent. Determination No. 2 shows carbon 70.47 per cent and hydrogen 5.63 per cent. Nitrogen found in the alkaloid amounted to 4.03 per cent.
Arcangelisia flava (Linn.) Merr. is believed to have a larger percentage of alkaloid than any other plant found in the Phil- ippines; and, should the therapeutic value of berberine become very important, even a small plant for the recovery of this al- kaloid would develop into a paying industry. The above cal- culations, together with the qualitative tests expressed, are suffi- cient to establish the Per of berberine in Arcangelisia flava (Linn.) Merr.
CASSIA SIMEA LAM. RissbweNeeae)
In the Philippines this tree occurs in cultivation only. It is commonly planted as a shade tree in Manila and in other large towns of the Archipelago. It is known by its Spanish name acacia, which is also applied to other trees of the same fam- ily. Cassia florida Vahl is a synonym. I can find no record of the tree serving any other useful purpose in the Philippine Islands than that of giving shade. :
A search of the literature revealed no record of any active principles found in this plant. However, a recent communica- tion from Father Algue, director of the Philippine Weather
4 The Philippine Journal of Science 1919
Bureau, states that the feeding of fresh branches and pods of this tree had caused the death of many of their hogs. For this reason a chemical analysis was made of the pods, branches, and leaves and the presence of a poisonous alkaloid established. 0.1015 gram of alkaloid gave 0.0725 gram of water and 0.2463 gram of carbon dioxide, which gave 7.93 per cent hydrogen and 66.18 per cent carbon; 0.1000 gram of alkaloid gave 0.0685 gram of water and 0.2385 gram of carbon dioxide, equal to 7.61 per cent of hydrogen and 65.04 per cent of carbon; 0.2016 gram of alkaloid gave 0.1415 gram of water and 0.4971 gram of carbon dioxide equal to 7.80 per cent of hydrogen and 67.25 per cent of carbon.
Percentages of carbon, hydrogen, and nitrogen in alkaloid from Cassia
siamea. Carbon. | Hydrogen.} Nitrogen. WMI Be Socar art iat eas spo es ohn 66.18 7.93 5.39 NE Bi Rit it ae ce 65. 04 A } Ss SE EES MON Pi ipspencr eons aca 67. 25 7.80 5.60 Le nea Ey RISC ORNE a Aaah a ent 198. 47 28.34 10. 99 BIONRG ks aac ice a SS 66. 16 1.78 5.495
These figures furnish data for an empirical formula for the alkaloid found in Cassia siamea, namely C,,H,,NO,. With in- traperitoneal injections of 1 cubic centimeter of a 5 per cent solution of the hydrochloride large guinea pigs readily exhibited symptoms of poisoning, usually resulting in death.
GEODORUM NUTANS AMES
Philippine names: Camaog, lubi lubi (Visayan) ; cola (Taga- log, from the Spanish word cola, meaning “glue’”’),
This plant is a terrestrial orchid that is found in thickets and in uncultivated open lands at low altitudes throughout the Phil- ippines, generally as scattered individuals, but occasionally abundant. Its only known use is that of an adhesive. The rhizomes are split and the pulp rubbed upon the surfaces to be glued. The plant is used throughout the Islands as a glue in the manufacture of stringed instruments. The water extraction of the plant gives a gum which is separated by precipitation with alcohol. This gum has exceptional strength and lasting power. The moisture content of the plant is 79.5 per cent. The yield of dry gum on the fresh plant is about 14 per cent, and on the moisture-free Sample, 68.8 per cent.
No substances of therapeutic value were found.
{>
a?
XIV,1 Wells: Philippine Medicinal Plants: III 5
CORIARIA INTERMEDIA MATSUMURA
This is the only representative of the small family Coriariaceae known from the Philippines and occurs at high altitudes in Mountain Province, Luzon; it is called buacat by the Igorots of Benguet, who claim that the fruit is inedible because it is poisonous. A glucoside is found to be present in very small quantities in the leaves and fruits of this plant. One hundred kilograms of the fresh plant give 69 grams of crude glucoside, which can be extracted by water or squeezed from the young shoots. The extract is treated in the usual manner with lead acetate, and the filtrate is freed from excess lead by hydrogen sulphide and evaporated to a sirup. From this the glucoside is extracted by alcohol and precipitated by ether.
Two cubic centimeters of plant extract, representing 20 grams of the fresh plant, intraperitoneally injected into a guinea pig weighing 700 grams, resulted in death after thirty minutes.
Coriaria is known in New Zealand as “toot-plant.” Landsay (30) has the following to say regarding this plant:
During a tour through the New Zealand provinces in 1861-1862, I was struck with the abundant evidences, which everywhere presented themselves, of the ravages produced among the flocks and herds of the settlers by the Toot-plant, one of the most common indigenous shrubs of these islands. In many cases of losses by individual settlers brought under his [their ?] notice, the amount of loss from this source alone had been from 25 to 75 per cent. In Otago, particularly, were such losses felt during the height of the gold mania there, from July to December, 1861: the traffic between Dunedin and Tuapeka gold-fields required the service of large numbers of bullocks, a great proportion of which were lost by Toot- poisoning. * * *
1. The Toot-poison belongs to the class of Narcotico-irritants. a. Its action on man includes the following symptoms:—coma, with or without delirium; sometimes great muscular excitement or convulsions; the details differing in different individuals; during convalescence, loss of memory, with or without vertigo. 6. In cattle and sheep, they include vertigo, stupor, delirium, and convulsions; curious staggerings and gyrations; frantic kicking, and racing or coursing; tremors.
2. The poisonous portion of the plant, (a) to man, is generally the Seed, which is contained in a beautiful, dark-purple, luscious berry, resembling the blackberry, which clusters closely in rich pendent racemes, and which is most tempting to children; occasionally the young Shoots of the plant, as it grows up in spring: (b) to cattle and sheep, in almost all cases, is the young Shoot, which is tender and succulent, resembling in appear- ance and taste the similar state of Asparagus.
CONCLUSIONS Arcangelisia flava (Linn.) Merr. (A. lemniscata Bece.) con-
tains berberine and shows approximately 4.8 per cent of pure alkaloid based on moisture-free wood. The plant material is
6
The Philippine Journal of Science "1919
soft and porous, and contains but small amounts of extractive matter that interferes in the recovery of the alkaloid. The re- covery of the alkaloid is simple and inexpensive, showing the plant to be an excellent source of the drug.
Cassia siamea Lam. contains an alkaloid with the formula C,,H,,.NO,.
The rhizomes of Geodorum nutans Ames contain about 14 per cent of a water-soluble adhesive.
Coriaria intermedia Mats. contains @ poisonous glucoside in its leaves and fruit.
(1)
(2)
(3)
(4)
(5) (6)
(7) (8)
(9) (10)
(11) (12) (13) (14) (15) (16) (17)
(18)
REFERENCES
Pommerehne, Arch, Pharm. (1895), No. 233, 127; Hare, Caspari, Rusby, National Standard Dispensatory. Lea & Febiger, Phila- delphia (1908), 307; Allen’s Commercial Organic Analysis, 4th ed. (1912), 6, 551.
Bédeker, Ann. d. Chem. u. Pharm. (1841), No. 66, 384; (1849), No. 69, 40; Hare, Caspari, Rusby, op. cit., 361; Allen’s Commercial Organic Analysis, loc. cit.
Mahla, F., Am. Journ. Sci. (1862), II, 33, 43; Allen’s Commercial Organic Analysis, loc. cit.; Hare, Caspari, Rusby, op. cit., 824; Perrins, J. D., Journ. Chem. Soc. London (1862), 15, 339.
Hare, Caspari, Rusby, op. cit., 1004; Allen’s Commercial Organic Analysis, loc. cit.; Gordin, Arch. Pharm. (1902), No. 240, 146, contending absence of berberine.
Schlotterbeck, J. O., Proc. Am. Pharm. Ass. (1901), 247.
Mayer, F. F., Am. Journ. Phar. (1863), 35, 289; Perrins, J. D., loc. cit.; Gross, E. Z., Journ. Chem. Soc. London (1873); Allen’s Com- mercial Organic Analysis, loc. cit.
Hare, Gaspari, Rusby, op. cit., 1720.
Stavart, L. W., Phar. Journ. (1848), 7, 74; Waring, E. D. Phar- macopea of India (1868), 12; Dymock, W., The Vegetable Materia Medica of Western India. Frubner & Co., London 2d ed. (1885), 37.
Mayer, F. F., op. cit., 97.
Buchner and Herverger, Ann. d. Chem. u. Pharm. (1837), No. 24, 228; Rudel, Arch. Pharm. (1891); No. 229, 631; Allen’s Com- mercial Organic Analysis, loc. cit,
Perrins, J. D., op. cit., 841.
Chevallier and Pelleton, Journ. Chim. Med. (1826), 2, 314; Perrins, J. D., op. cit., 342.
Stenhouse, J. W., Ann. d. Chem. u. Pharm. (1855), No. 95, 108; (1858), No. 105, 360; Pharm. Journ. Trans. (1855), 14, 455.
Pommerehne, loc. cit.
Mayer, F. F., Journ. de Pharm. et de Chim. (8) 46,.496. Some authors claim that Leontice thalictroides is identical with Caulo- phyllum thalictroides.
Perkin, A. G., Chem. Soc. Trans. (1897), 71, 1198.
Bédeker, Ann. d. Chem. u. Pharm. (1841), No. 66, 384; Chem. Gaz. VI,.No. 69, 40; Gordin, loc. cit., contradicting Bédeker.
Schlotterbeck, J. O., Am. Journ. Pharm. (1902), 74, 584,
hes
Le |
ef
XIV, 1 (19)
(20) (21) (22)
(23) (24) (25)
(26) (27) (28) (29) (30)
Wells: Philippine Medicinal Plants: III 7
Perrins, J. D., Ann. d. Chem. u. Pharm. (1852), 83, 276; Journ Chem. Soc. London (1862), 15, 389.
Idem, Journ. Chem. Soc. London, (1862), 15, 340.
Geacosa and Soave, Am. Journ. Pharm. (1890), 62, 500.
Wood, Remington and Sadlter, U. S. Dispensatory. J. B. Lippincott & Co., Philadelphia, 19th ed., 1678.
Steere, Am. Journ. Pharm. (1867), 39, 337.
Stenhouse, Pharm. Journ. Trans. [8], 46, 495.
Gastel, Jahresbericht iiber die Forstchritte der Chemie und ver- wandter Theile andere Wissenschaften (1866), 480.
Martin, Pharm. Journ. Trans. [8], 13, 337.
Gordin, loc. cit., contradicting Mayer.
Brill and Wells, Philip. Journ. Sci., Sec. A (1917), 12, 167.
Gaze, Arch. d. Pharm. (1890), No. 228, 607.
Landsay, W. Lauder, Journ. Bot. (1863), 1, 247.
ILLUSTRATION
PLaTe I
Fic. 1. Berberine-acetone compound. x 110. 2. Quick crystallization of the hydrochloride of the alkaloid.
9
{Puruir. Journ. Sct., XIV. No. 1.
WELLS: MEDICINAL PLANTS, III.]
Berberine-acetone compound.
oil) phe be
Fig. 2. Quick crystallization of the hydrochloride of the alkaloid.
PLATE lt.
THE TREATMENT OF HUMAN BERIBERI WITH AUTOLYZED YEAST EXTRACT
By N. M. SALEEBY (Manila)
The extract of rice polishings has become recognized as one of the most efficient remedies for the treatment of infantile beri- beri: However, it does not markedly improve cases of long standing. |
Williams and Saleeby ? have shown that the hydrolyzed ex- tract does have a prompt and decisive action on these more chronic cases, but that it must be administered only under the direct supervision of the physician on account of its poisonous qualities when given in excessive doses. These investigators believe that the poisonous nature of the hydrolyzed extract is due to the choline present.
That polyneuritis in fowls is improved by treatment with yeast has been known for some time. Cooper found that no poisonous effects followed the daily dose of 30 cubic centimeters of autolyzed yeast extract to chickens and that the administra- tion of 100 cubic centimeters did no harm.
In order that this extract might be tried on human beriberi, in 1917 and 1918 the Bureau of Science prepared and delivered to me in 50 cubic centimeter bottles an autolyzed yeast extract and requested me to try its efficacy when given to human pa- tients. Brewers’ yeast was obtained from the San Miguel and the Oriental breweries, of Manila, separated from the adhering beer and placed in an incubator at a temperature of 35° C. until it had assumed a mushlike consistency (about forty-eight hours) due to autolysis. The mass was then filtered through paper, washed on the filter, and the filtrate concentrated under a partial vacuum at a temperature below 60° C. to a volume of about one-third of the original.
* Albert, J., Philip. Journ. Sci., See. B (1915), 10, 81. The Bureau of Science, Manila, manufactures about 400 liters of this extract annually for use in the Philippines.
? Williams, R. R., and Saleeby, N. M., Philip. Journ. Sci., See. B. (1915), 10, 99.
* Cooper, E. A., Bio-chem. Journ. (1914), 8, 250. | 11
12 The Philippine Journal of Science
A concise summary of my findings when the autolyzed yeast extract was given to human patients is as follows:
1. About two score cases were treated; five were children below 2 years of age; ten were treated in hospital; all others were out-patients.
2. Adults were given from 15 to 40 cubic centimeters three times a day. Children were given from 2 to 4 cubic centimeters every three hours, or six times a day. Bigger doses did not seem to give better results. No sign of poisoning was observed.
3. Only acute and uncomplicated symptoms of beriberi were observed under treatment. Chronic nerve, muscular, or cardiac lesions were actually unaffected.
5. All acute peripheral symptoms of neuritis were affected quickly. Marked results were noted in less than three days, and a week’s treatment seemed to give full relief in mild acute cases. Treatment was generally followed up for two weeks at least.
6. Infantile-beriberi symptoms were relieved with comparative rapidity. £dema yielded quickly, and nutrition improved at once.
7. No special diet was prescribed. Patients were given re- gular hospital diets in accordance with the state of their digestion.
8. Children receiving the extract continued to nurse at the mother’s breast.
9. The effect of the autolyzed yeast extract used is similar to that produced by the hydrolyzed extract of rice polishings; it seemed weaker, however.
yr
A PHOTOGRAPHIC STUDY OF LEPROSY:
. By Oswatp E. DENNEY (Chief, Culion Leper Colony, Culion, P. I.)
FOUR PLATES
The great variety of typical lesions of leprosy has rendered it impracticable completely to illustrate the disease in the aver- age textbook; it seemed desirable, therefore, to present a pho- tographic study showing the progression of the external lesions.
The clinical manifestations of leprosy have been so fully described by the many students of the disease that discussion at length in the present paper is not necessary. The disease is generally considered to manifest itself in two distinct types— the “nodular” and the “maculo-anesthetic.” A combination of symptoms of these two is recognized as the “mixed” type. In this study the two principal types only will be considered; the mixed type, obviously, may present any composite picture of the nodular and maculo-anzsthetic types.
Since the manner of entrance into the body of the causative agent of the disease (Mycobacteriwm lepre, or Bacillus leprz Hansen) is unknown, the initial lesion cannot be demonstrated with certainty; however, the earliest recognized lesion can be illustrated (Plate I, figs. 1 to 9; and Plate II, figs. 10 to 15). The progression of the lesions of the nodular type as indicated in the above series may be reproduced in practically any part of the body.
The photographable manifestations of uncomplicated maculo- anesthetic leprosy are mainly confined to the macules, which appear chiefly on the back and face, but which may appear on any part of the body; the deformities that result from motor- nerve destruction; and the trophic ulcers that result from dis- turbed nutrition. The deformities of uncomplicated maculo- anesthetic leprosy in the hands are illustrated by Plate II, figs. 16 and 17; and Plate III, figs. 18 and 19.
Plate III, fig. 20, illustrates the typical perforating ulcer of the foot; this lesion is considered as diagnostic of leprosy by the natives in many parts of the world.
* Received for publication, September 6, 1918. 13
14 The Philippine Journal of Science
Plate III, fig. 21, illustrates the typical, sluggish, neurotrophic ulcers, which although almost incurable appear to have a strong resistance to the ordinary pyogenic infections. Here, too, is shown the curious parchmentlike skin frequently seen among anesthetic lepers.
The macules of the maculo-anesthetic type are reproduced with difficulty, particularly in the dark-skinned races, because of the lack of contrast (Plate III, figs. 22 to 25).
Another lesion of leprosy that, due to its great prevalence among the Filipino lepers, deserves special description is the condition of bone necrosis and absorption commonly seen in the feet and hands. The condition is generally described as of the maculo-anesthetic type and is probably not entitled to classifi- cation as a special type. The condition may be seen rarely among the pure nodular types, commonly among the maculo- anesthetic and mixed types, and occasionally among lepers who fail to show coincident evidence of progressive nodular or maculo- anesthetic symptoms. The complete series of changes exterids over a number of years and therefore may be followed with great difficulty in individual cases. The sequence appears to be much as shown in Plate IV, figs. 26 to 38.
The process of absorption as indicated above usually does not continue without complications from trauma and secondary in- fections; the bones being near the surface and unprotected by the normal connective tissue pads of the finger tips, sinuses frequently form, from which necrotic bone is discharged. An instance is recalled of a patient, since dead, in whom the five finger nails of one hand remained attached in a much distorted condition at the site of the radiocarpal articulation, the bones of the entire hand having been absorbed without rupture of the skin from trauma.
It is not to be inferred from this series of photographs that each case of leprosy progresses by rule to a definite classical physical picture; there is perhaps no disease so capricious in the manifestations of its clinical progress.
ILLUSTRATIONS
PLATE I
Fig. 1. A maculo-papular lesion of three years’ duration on the cheek of a 6-year-old Filipina, which up to the present time is her only demonstrable lesion of leprosy. The spot, about 2 centi- meters in diameter, is slightly elevated above the normal skin surface; it is pink and contains numerous small nodules in which the causative organism can be found. A lesion of this character may remain practically unchanged for years; may almost entirely disappear, leaving a pale or pigmented, smooth spot; or it may grow progressively larger with the coincident appearance elsewhere of similar spots, as in fig. 2.
2. Maculo-papular lesions of leprosy on each cheek and on the chin.
3. An apparent latency of the macules of leprosy; which, in this case, are neither elevated nor nodular, but are smooth and faintly pigmented and as such cannot be distinguished from the _ numerous tinea, etc., that are frequently met with in the | tropics. In this and in the succeeding illustrations may be seen the progressive infiltration of the tissues over the inner half of the superciliary ridge, giving rise to overhanging eyebrows, suggesting a frown. Mention is frequently made of the loss of the hair of the outer half of the eyebrows as an early and diagnostic symptom of leprosy; this is not present in the cases shown in figs. 1 to 3.
4. A case of leprosy, relatively older than those of figs. 1 to 3, showing a thinning of the outer half of the eyebrows as well as the early nodular infiltration of the nasal ale and the helix and lobule of each ear.
5. A somewhat more advanced case of leprosy with a nodular infiltra- tion extending over the face. The nodules are small with the exception of one on the chin. Complete loss of the hair of the outer half of the eyebrows is here shown. A small amount of edema of the eyelids is present. ;
6. The nodules are larger and more prominent than in the preceding eases. This and figs. 7 to 9 illustrate the loss of normal contour of the nose from the destruction of cartilaginous tissue.
. 7. In addition to the diffuse infiltration of the face, there are well-marked infiltration of the lips and slightly pendulous ear lobules.
8. The nodules, as discrete tumors, are surrounded by apparently normal tissue. A considerable loss of the cartilage of the tip of the nose has caused a marked flattening of this appendage.
9. Illustrating shotlike tubercles of leprosy as discrete nodules, scattered over the entire face; the arms and the legs, and to a lesser extent the trunk, showed similar tumors.
1628232 15
16
Fie.
Fig.
The Philippine J ournal of Science 1919
PLATE II
10. Showing a not uncommon condition in leprosy, in which the
nodules themselves undergo necrosis with subsequent absorp- tion, leaving smooth cicatrices. Necrosis of the cartilage of the left ear and of one nodule on the left cheek is here in progress.
11. Showing the partial coalescence of large nodules on the cheeks
12
and chin; this condition in advanced cases of leprosy gives rise to the leonine facies.
. A profile view of a case of early leontiasis, showing a diffuse thickening of the skin of the face. This is an excellent example of pendulous ear lobules.
18. A slightly more advanced case of leontiasis, showing the loss of
the normal lines of expression of the face, notably in the distorted lips.
14, A still farther advanced case of leontiasis; the general thickening
of the tissues of the face has given rise to a “death-masklike”’ appearance. Leprous cachexia is well marked in this woman.
15. A fairly typical case of leontiasis. This may be considered as
16.
the terminal manifestation of uncomplicated nodular leprosy in the face.
A typical “ring and little finger deformity,” the earliest recogniz- able deformity of this tyne of leprosy in the hands. Both fingers can be straightened with only moderate force and at this stage retain some function.
17. A moderate contraction in all the fingers in leprosy; both thumbs,
18
in this case, appeared to be normal. At the instant the picture was being taken, a moderate pressure was being exerted on the fingers to show the approximate amount of available extension.
PLATE III
. A more nearly complete contraction of the fingers than in fig. 17; here, too, the limit of extension is shown. The cedema present in the fingers of the left hand is transient and is due to an infection in the palm of the hand.
19. An example of the claw hand of leprosy, the classical main en
20.
griffe; the typical atrophy of the interossei is indicated in the left hand. The condition of this hand may be considered as the terminal manifestation of anzsthetic leprosy of the hands in uncomplicated cases. Unfortunately, the disease rarely stops with this deformity. Due to the coincident anesthesia, the hands are subject to trauma, particularly to burns, which may be very extensive and are usually painless. Other trauma and neurotrophic changes result in various deformities.
. The typical perforating ulcer of the foot; this lesion is considered by the natives in many parts of the world as diagnostic of leprosy.
21. The typical, sluggish, neurotrophic ulcers of leprosy, which
although almost incurable appear to have a strong resistance to the ordinary pyogenic infections. The curious parchmentlike skin frequently seen among anesthetic lepers is shown.
AIV
FIG.
FIG.
22
23. 24,
"25.
26.
27.
28.
29.
30. 51.
82.
33.
Denney: Photographic Study of Leprosy 17
A single, large patch on the back of a leper having a slightly pigmented, rugged, central area and a slightly erythematous periphery.
An almost diffuse outcropping of small erythematous macules of leprosy, not unlike those of secondary syphilis.
The coalescence of numerous macules of leprosy, giving rise to curious circinate designs.
A somewhat unusual herpeslike series of macules of leprosy.
PLATE IV
An undeformed hand, aside from the slight spindle shape of the fingers; the proximal portions being about normal in appear- ance, the distal phalanges being smaller and pointed.
An obviously deformed hand, the spindle shape being greatly exaggerated. Unquestionably in this case of leprosy the osseous tissues are not alone in the retrogressive process.
The process of absorption is in progress, and there is some distortion of the digits from coincident nerve involvement. The thumb of each hand in this case is unattacked.
A more advanced stage; in this case the nails may be seen in their deformed state almost at the point of articulation of the first and second phalanges.
The proximal phalanges are almost completely absorbed, the thumb of the right hand alone having escaped the process.
A similar irregularity in the absorption of the fingers, the middle finger of the left hand being unabsorbed.
The peculiar “telescoped” appearance occasionally seen, in which the process of absorption of the osseous tissue has proceeded more rapidly than that of the other tissues.
The partial absorption of the metacarpals of the left hand; the distorted finger nails remain as horny projections on the palmar aspect of the hand. The right hand shows a long scar at the site of the metacarpo-phalangeal articulation, the result of amputation of infected fingers. The left hand shows no scars since the skin has remained unbroken during the entire process.
DENNEY: STUDY Or LEPROSY.] {Puiuip, Journ. Scr., XIV, No. 1.
Fig. 1. Fig. 2. Fig: 3.
Fig. 4. Fig. 5. Fig. 6.
Fig. 7. Fig. 8. Fig. 9. PLATE lI.
DENNEY: STUDY or LEPROSY.] {Puitte. Journ. Scr., XIV, No. 1.
Fig. 13. Fig. 14. Fig. 15.
Fig. 16. Fig. 17. PLATE Il.
DENNEY: STUDY OF LEPROSY, ] {Puinte, Journ. Sct., XIV, No. 1.
Fig. 21. Fig. 22.
Fig. 23, Fig. 24. Fig. 25, PLATE ill.
DENNEY: STUDY oF LEPROSY.] [PuHitte, Journ. Sct., XIV, No, 1.
Fig. 26. Fig. 27.
Fig. 28. Fig. 29. Fig. 30.
Figs 3A. Fig. 32. Fig. 33. PLATE IV.
A COMPARATIVE STUDY OF DIFFERENT METHODS OF TREATMENT OF TYPHOID FEVER*
By Pepro T. LANTIN
(From the Department of Medicine, College of Medicine and Surgery, University of the Philippines, and the Clinics of the Philippine General Hospital, Manila)
TEN TEXT FIGURES
CONTENTS INTRODUCTION. VARIETY OF TREATMENT—Continued. PRESENTATION OF THE CLINICAL Foreign protein—Continued. CASES. Nonsensitized vaccine. Period of observation. Intravenous. Source of material. Peptone. Type of epidemic. Intramuscular. Morbidity and mortality. Milk, Selection of material. Intramuscular. Clinical grouping of cases. Colloidal preparation. VARIETY OF TREATMENT. Colloidal gold (colibiase). Foreign protein. Intravenous. Sensitized vaccine. DISCUSSION. Intravenous. Specificity of the treatment. Controls. Nonspecificity of the treatment. Intramuscular. SUMMARY AND CONCLUSIONS. INTRODUCTION
Life is short and art long; opportunity is fleeting; experiment is dangerous and decision is difficult.—First Aphorism of Hippocrates.
The question of the therapy of typhoid fever has been given considerable attention by scientists for the last three years. It now forms a new field of scientific research, among both clin- icians and laboratory workers. Medical literature teems with reports of the favorable results obtained by different observers of the merits of the various methods employed; namely, the use of (a) foreign proteins and (b) colloidal preparations. These methods of treatment may be said to be still in the experimental stage. After three years of careful trial and observation, the views expressed by leading investigators with particular refer-
‘Thesis submitted in partial fulfillment of the requirements for the degree of Doctor of Tropical Medicine, in the Graduate School of Tropical Medicine and Public Health, University of the Philippines, February 21,
1918. 19
20 The Philippine Journal of Science 1919
ence to the action of vaccines are many, and opinion is far from unanimous. The claims made by some, that the curative effect of vaccines is due to their specific action, have been held to be untenable, so that many look upon the question as still unsettled.
It is my intention to make the present paper the basis of my contribution to this much-disputed question, although conscious of the fact that it requires some temerity to enter a field already occupied by so many distinguished American and European writers. I hope, however, to set forth some facts in connection with these methods of treatment and then to present the con- clusions reached through my observations.
PRESENTATION OF THE CLINICAL CASES
Period of observation.—The present investigation covers a period of seven months, beginning August, 1917, and extending to February, 1918. During that time there were admitted to the medical department in the Philippine General Hospital nine- ty-eight cases of typhoid fever, all Filipinos. Both sexes are represented in the series. The minimum age was 14 years. Another series of twenty cases of typhoid fever has not, been included with these ninety-eight cases for the reason that some were in a dying condition on admission and, therefore, short-lived in the hospital; and others were admitted in a con- valescent state, in which they showed marked defervescence. In connection with these convalescent cases it was felt that the effects of the treatment under consideration in this paper might lead to erroneously favorable interpretations.
Source of material—tThe source of the cases studied was the district of Manila. Relatively few cases came from Rizal, Ca- vite, Bulacan, and Laguna Provinces.
Type of epidemic.—Many of the patients on admission showed marked toxemia, frequently associated with pneumonic, cardiac, or renal complications; while other cases were admitted in a condition of collapse, either with intestinal perforation or acute intestinal hemorrhage. It can be fairly stated, then, that we were dealing with a severe type of epidemic. It should be fur- ther stated that, with very few exceptions, these typhoid cases belonged to the laboring class of the community, whose hygiene and dietary were very deficient. Upon falling ill many of them remained in their homes for a number of days without any med- ical attendance, and only applied to the hospital for admission when their condition had become very serious.
In these ninety-eight cases males predominated over females. The sex incidence is shown in Table I.
XIV, 1 Lantin: Treatment of Typhoid Fever VAI
TABLE I.—Sex incidence in typhoid fever.
Sex. Cases. Deaths. Per cent. MiBIO 6S aah ee Sa ee 65 14 21.5 GING Soria eae ey bee aie ee 33 5 15.1 Weel is 2 ee 98 19 | 19.38 | : ee cued
Morbidity and mortality—Out of these ninety-eight cases there were nineteen deaths, a mortality of 19.38 per cent, a very discouraging if not alarming figure. It should be remembered, however, that many of the cases showed little prospect’ of re- covery, on account of their serious condition when admitted to the hospital. In fact, ten of the nineteen cases that died were considered hopeless on admission. Excluding these ten hopeless cases, therefore, reduces the mortality rate to 10.22 per cent. McCrae(31) gives 25 per cent as the mortality rate for British troops in South Africa; Curschmann,(5) 9 to 12 per cent; Os- ler,(837) 7 to 20 per cent in hospital practice, and 5 to 12 per cent in private practice; Rogers,(42) 16.3 per cent for white troops in the tropics and 26 per cent for Indians. In the Phil- ippines Chamberlain(3) places the mortality rate at 17.65 per cent for Filipgios and 16.8 per cent for white troops in the tropics. Gutierrez,(12) of the Philippine General Hospital, in analyzing one hundred twenty-five cases of typhoid fever in 1913, gives 20.43 per cent; after excluding ten hopeless cases he gives a mortality rate of 13.13 per cent.
Selection of material.—Selection of cases is fraught with no less difficulty. The varying degree of severity of infection in each case, and the fact that some individuals came early for treatment while others came later, rendered comparison a dif- ficult task. However, particular emphasis was laid on the se- verity of the individual case on admission. The cases were then grouped. It should be stated that the diagnoses in all these ninety-eight cases were established on clinical findings, and lab- oratory examination was then resorted to for confirmatory pur- poses. In each instance search was made for malarial parasites.
Clinical grouping of cases.—These ninety-eight cases were divided into groups according to the apparent condition of the individual case on admission or after one or two days’ obser- vation in the ward. ‘Thus, cases that presented high fever and delirium, with or without complications, were classified as severe and toxic; those that presented high fever, with or without complications, but not apparently poisoned, were classified as
22 | The Philippine Journal of Science 1919
severe and nontoxic; while those with moderately high fever, without complications, and not apparently poisoned, were classi- fied as mild. These classifications are, of course, more or less arbitrary and conventional. Classifications were made under these headings as follows:
TaBLE I1.—Classification of cases of typhoid fever.
Cases.
Severe and toxic 26 Severe and nontoxic 47 Mild 25
Total 98
VARIETY OF TREATMENT FOREIGN PROTEIN
Bacteria, being composed of protoplasmic matter, are con- sidered to be protein substance. In fact, Robertson,(40) and Jobling, Petersen, and Eggstein,(17) have called this substance “bacterial protein.” My view is that any organism, living or Haida becomes foreign protein when introduced into the
ost.
Typhoid fever, so far as I am aware, is the only disease in the treatment of which protein has been extensively employed. It has been used either in homologous or heterogonous forms. In the great majority of instances, however, vaccines in the form of foreign protein have been used. These consisted of either living sensitized organisms, dead sensitized organisms, or non- living nonsensitized organisms. Sensitized organisms are bacilli that have been treated with immune serum, while non- sensitized nonliving organisms are killed bacilli that have not been treated with immune serum.
SENSITIZED, OR TREATED, VACCINE ADMINISTERED INTRAVENOUSLY
Vaccine treatment dates from 1893. Eugene Fraenkel(7) was the pioneer in this field. He employed a vaccine of killed typhoid bacilli, subcutaneously administered, for therapeutic purposes in typhoid fever, and he claimed to have modified the course of the disease. His work received scant attention from early investigators. Nine years passed before reports of similar observations came from Petruschy(38) in 1902. Then followed the work of Pescarole and Quadrone(39) in 1908. Ichikawa, (15) in 1914, used the intravenous method of administration of living sensitized typhoid vaccine and secured excellent results. His success awakened interest in this form of treatment: and since then, according to Gay and Chickering, (11) it has received care- ful trial at the hands of such leading investigators as Koranyi,
XIV, 1 Lantin: Treatment of Typhoid Fever 23
Biedl, Eggerth, Sladek and Kotlowski, Boral, Holler, Lowy, Luksch, and Wilhelm and Myer.
Variety of sensitized typhoid vaccine.—So far as I am aware, there are four kinds of this type of vaccine; namely, (a) Ichikawa’s living attenuated sensitized vaccine, (0) Besred- ka’s(1) living sensitized vaccine, (c) Gay’s(9) sediment vaccine, and (d) sensitized killed vaccine.
Dosage.—The dose administered intravenously varies accord- ing to the kind of vaccine. Thus, of Besredka’s vaccine there have been used from 100 to 300 millions; Ichikawa’s vaccine, from 200 to 300 millions; Gay’s vaccine, from 0.2 to 0.4 milli- gram (150 to 300 millions). The dosage of killed sensitized vaccine is from 50 to 800 millions as indicated by Jobling ; (17) 70 to 300 millions, by Dithorn and Schultz ;(6) and equal parts of typhoid and paratyphoid bacilli (500 millions) is the amount employed by Robertson.(40) I have employed a dosage of from 250 to 1,000 millions of killed sensitized typhoid bacteria in- travenously, increasing the doses every three or four days ac- cording to the case.
Contraindications.—According to eminent writers on the sub- ject, weakness of the heart, presence of pneumonia, and intesti- nal hemorrhage are contraindications for vaccine treatment. Thus Sladek and Kotlowski(46) believe that it increases peris- talsis of the intestines, with subsequent danger of hemorrhage and perforation. My experience leads me to believe that vaccine therapy is as yet of very limited applicability, and I do not feel that I am in a position to confirm or controvert their observa- tions. However, I have employed this treatment in all condi- tions, except in cases of intestinal hemorrhage, and so far there have been no untoward effects that could be attributed directly to the treatment. :
This series comprises fifty-one cases of typhoid admitted during the height of the epidemic, of which thirty cases were subjected to intravenous injection of polyvalent sensitized typhoid vaccine, while twenty-one cases were used as controls.
The clinical grouping of cases given vaccine treatment intra- venously is shown in Table III.
TABLE I11.—Condition of patients before treatment.
Cases. Severe and toxic 9 Severe and nontoxic 7 Mild 30
Total
24 The Philippine Journal of Science 1919
Method of treatment.—The view that sensitized typhoid vac- cine is considered less toxic than nonsensitized typhoid vaccine seems to be the consensus among investigators at present. Cecil,(2) Garbat,(8) and Nichols(35) have shown by experiments with animals that such is the case. Cecil, however, has found that the lethal dose of sensitized typhoid vaccine is three times as large as that of the nonsensitized bacilli. Reasoning from this point of view, since McWilliams(34) has used intravenously 500 millions of plain nonsensitized killed typhoid bacilli as the initial dose, the safe limit of dosage for sensitized organisms would be 1,500 millions; I have used, therefore, 250 to 500 millions as my dose and, in a very few cases, 1,000 millions. I have never exceeded 1,000 millions, even in repeated doses.
The vein selected for intravenous injection is the median basilic, this vessel being commonly prominent, although the injection may be given in any other vein provided the site is rendered aseptic. The injection should be done under rigid . asepsis and preferably by the closed method.
The results of the treatment of thirty cases by intravenous injection of sensitized vaccine are shown in Table IV.
TABLE 1V.—Sensitized typhoid vaccine administered intravenously.
Cases. Days | Dura- | Dura- Classification by results. Sivene pee er Somot | oe. Mild. \Severe.| and ment. | ment. | ease. toxic.
Days. | Days. Aborted ._._ x 4 8 0 * 8.2 5.1} 18.8 FROIN ao oak 2 12 0 14 11.5 14.4 | 25.9 Relatively unaffected _.......__..__.__ 0 0 8 8 8 25.8 | $3.8 Deaths o ae 0 0 6 i ETS ed ae een premiers Crisitz a ao EK OPO EE OER Peas , SS Rane Sancta Rae Ae LRG a es chm ee onuinnkwtwccunee:. BO feecencchcwcck ticsewsey
sub luclgaldamtierenpspetgs Sacer 6 eset Sn ee 24.1
In Table IV the cases have been separated into groups according to the results; namely, (a) aborted type, (b) benefited type, and (c) relatively unaffected type.
There were seven aborted cases out of thirty cases treated intravenously, with an average duration of treatment of 5.1 days, in contrast to seven days observed by Gay.(9) McCrae(32) in analyzing fifteen hundred cases found 0.1 per cent that re- covered by crisis. In my series, I found 28.33 per cent of aborted cases. It is interesting to note that the aborted cases were observed during the first week, and that they have a direct
XIV, 1 Lantin: Treatment of Typhoid Fever 25
relation to intravenous injections. This abortive type was ob- served in mild cases in the majority of instances and in severe cases in a few instances. The temperature record of one of the abortive cases is shown in the accompanying chart (fig. 1).
iS 6th day lth. day. th day. 9th day. | se PM. A.M. | P 4} ALM. P M. A. M™. RM.\| AN P| 10\2 6 10} 2 6 10\2 6 10\246 8 lo/A2 46 B/0I2\2 6126 lle sl} 1 | sity S {1 LB ft = SRN & NS NN SS 8S +o sen bs aot || sett Tl tore) Th 7 xs se) Bd 377 \ \ LY TOo 36 \
Fic. 1. Temperature chart of B. Y. Abortive type of typhoid fever, treated with sensitized typhoid vaccine intravenously.
The benefited type was observed during the second week. As a rule the temperature drops, either by crisis or by lysis, fol- lowing each successive intravenous injection; but afterward it rises again temporarily, then becoming permanently normal. The average duration of treatment was 14.4 days in my cases, while in those of Gay it was 15.8 days. Examples of the ben- efited cases are shown in the accompanying charts (figs. 2, 3, and 4).
The relatively unaffected type was observed in advanced cases. Each injection was followed by a temporary drop in temperature, which subsequently in some cases resumed the original level at which it was before the injection, while in others it became slightly remittent or intermittent. The course of the disease was slightly altered. The average duration of the disease was 25.3 days in this series.
Symptomatology.—From thirty minutes to one hour after the intravenous injection of vaccine, the patient as a rule feels a slight chilly sensation as a prodromal symptom. This lasts for a few minutes; then follows the real shaking of the entire body. This rigor shows varying degrees of intensity according to in- dividual susceptibility, and may last for from fifteen to thirty-
96 The Philippine Journal of Science 1919
five minutes. During this period the pulse and the respiration are slightly increased in rate, and the skin is pale and feels cold; the temperature is usually high, reaching its maximum height in from three to six hours. It then falls, generally either by crisis or by lysis, or else it may become intermittent or re- mittent. There are cases, however, in which the temperature drops by crisis or lysis without chills or a preceding rise in temperature. Such cases are relatively rare. The crisis may
BS 13th day. 14th day. (5th day, | 6th day S| Am. PM. A.M. |PM\|AMILPMIAM S| 2 6/012|\2 468 10/2\2 4 6 B/0\2 6 Wl? 6/126 102 6 10 31. aS ES REN SPF SS Sy] y Siz SIS QSi8 SES § SSS SMM ESES 40" SSP sip 39° = 2. NS 38; ws 6 6 \ Nei role la 37{- 7 oad 5
Fig. 2. Temperature chart of E. .N. Benefited type of typhoid fever, treated with sensitized typhoid vaccine intravenously.
/4.th day. (5th day. (6th day. ‘7th day. AM PM.| AM IPM. A. MM, PM, AM P i, 15/02 6 102 6 142 6/0122 46 81122 46 BIO? 6102 6106
ar Ss ty bihahe = TSptaig : Shige cps S SSS = Ou. bs 3g le 36 (@; , ont nN. ba oe 37 on
Fic. 3. Temperature chart of M. L. Benefited type of typhoi sensitized : d fever, trea typhoid vaccine intravenously, on
XIV, 1 Lantin: Treatment of Typhoid Fever 27
If th day. } 12 th day. 13 th day. 14th day 15 th doy. 16th day. AMT eM |AM.| OP OM. AM: P.M. AMP M.|AM| PM, AM.[P M. iS 26 Wi26 1026 026 Wi2)\24+6 8 1212 46 810l2\2 6 12 6 0\2 6 10i'2 6/126 WiI26 » Fe
Sit = S = hi S Sane 31] 8
= S ese |i] |B
PSNI 5 § #1 re St
et te } se secs Bis o sed aA cn SE ae ‘sr ‘an Ri v Sor tT 37) ; Oj N. o O Noo
Fic. 4. Temperature chart of N. C. Benefited type of typhoid fever treated with sensitized typhoid vaccine intravenously.
reach a normal or a subnormal level about twelve hours after injection. The rigor is followed by thirst, cold perspiration, and relaxation, but accompanied by a feeling of marked alleviation of subjective symptoms. In the majority of instances the pa- tient, previously sleepless, is able to sleep soundly the following night. |
The temperature may remain permanently at the normal level, and in this event no further injection is necessary; but, if the temperature should rise again for a period of three or four days, another injection is needed with increasing dose. My ex- perience is that two or three doses are sufficient to produce the desired result; if without result, further injections seem to be of no value.
According to Gay and Chickering,(11) and MeWilliams, (34) there is a leucopenia during the rise of temperature, and hyper- leucocytosis during the apyretic period. They were able to ob- serve these phenomena by frequently examining the blood of the patients. I was unable to make frequent examinations of the blood of the patients injected, but examination of the blood twenty-four hours after injection revealed a slight increase in the leucocyte count.
I have observed that a moderate reaction is very necessary to produce beneficial results. Similar observations have been confirmed by Gay(9) and claimed by Leake. (24) To avoid errors in interpretation of results, it is highly advisable to base one’s judgment on the effects of treatment; that is to say, not from the subjective symptoms, but rather from the objective phenomena, such as shortening of the duration of the fever or,
28 The Philippine Journal of Science 1919
in other words, the occurrence of the abortive type in relation to injection.
Complications.—Excluding eight cases, in which complications were already present on admission into the hospital, six de- veloped complications during treatment. In ninety-eight cases treated by Gay,(9) he observed thirteen that developed com- plications; namely, pyelitis, one case; lobar pneumonia, one; laryngitis, two; bronchopneumonia, two; toxemia, one; hzemor- rhage, four; and perforation, two.
Table V shows the complications that were observed during treatment and before treatment was begun.
TABLE V.—Complications before and during treatment.
Devel- | Devel- oped oped Complication. a before | during treat- treat- ment ment PUMICE ans oro esa oo ae oe at Oo oe ee 8 3 Ri Ceebisinh HOiOPTNee es so a eee oe © 0 b2 Br hop WM ah ea icg ke SSE EN odes wh as oa dbuwa vated saul obab ink 1 1 RUQUAE CROONER bs ge ee ae ee 9 6 i eae
* Relapses, three cases. » One case had hemorrhage four days after injection ; another case, during convalescence.
Early investigators, Krumbhaar and Richardson, (22) Waitz- felder, (48) and Robertson,(40) held the belief that vaccine therapy diminishes the complications. But Table V seems to show that it has no advantageous effect on the complications as compared with my controls. Whittington,(49) who has had considerable experience with vaccine therapy, reports that he observed a higher percentage of complications (49.5 per cent) under vaccine treatment, while his controls showed 46 per cent. His observation is based upon one hundred fifteen cases treated with vaccine and another one hundred fifteen under classical treatment.
Relapses.—In my thirty cases, treated with vaccine, three had relapses, lasting only a few days. Gay advised subcuta- neous injection of vaccine a few days after the intravenous, so as to prevent relapse. Again, Whittington found a higher per- centage of relapses in cases treated with vaccine (10.4 per cent), in contrast to 7.8 per cent observed in his controls. In my controls I had five relapses (23.9 per cent), a higher number than shown by the cases that had undergone vaccine treatment
(10 per cent). This difference in results may be due to the limited series that I have had so far.
XIV,1 Lantin: Treatment of Typhoid Fever 29
Concomitant disease.—On examining these thirty cases, two cases of tuberculosis were found. One was a case of incipient pulmonary tuberculosis that later became active during the course of the disease. It seemed that vaccine treatment ad- ministered intravenously had done harm to the patient; because, after the injection and consequent shaking up of the body, it was noticed that traces of blood were found in his sputum. This might be a mere coincidence, but it should be regarded with suspicion. It seems advisable to exercise prudence and caution in the use of vaccine for patients suffering from pulmonary tuberculosis. The other case was a tuberculous cervical aden- itis. In this particular case vaccine injection was not followed by any untoward effects.
Mortality.—The mortality in these thirty cases is 20 per cent, a very high rate. It should be remembered, as already stated, that these patients belonged to the laboring class who did not realize the advantage of early hospitalization. Consequently they had remained in their respective homes without adequate treatment and care, only coming to the hospital at a time when medical attention would be of little avail because of the advanced stage and seriousness of the cases. In fact, there were three cases in which I considered the outlook on admission as hopeless on the grounds of marked toxemia and pulmonary complica- tions. By excluding these three hopeless cases, the mortality is reduced to 10 per cent. Autopsy findings will reveal the causes of death, as shown in the following protocols:
Autopsy findings (sensitized intravenous treatment).
File No. 1957: D. H.
Anatomic diagnosis: Bilateral lobar pneumonia with abscess and gangrene of the lung; typhoid enteritis; acute parenchymatous degeneration of the viscera; chronic fibrous pleurisy.
File No. 1880: V. C.
Autopsy findings: Typhoid ulcerated enteritis, healing; acute hzmor- rhagic bronchopneumonia; acute pyonephritis; parenchymatous de- generation of the liver; fatty degeneration of the heart; acute myocarditis.
File No. 1875: S. C.
Anatomic diagnosis: Intestinal hemorrhage; acute ulcerative entero- colitis, typhoid; acute splenitis, mesenteric; parenchymatous degen- eration of the heart and liver; acute parenchymatous nephritis with some interstitial nephritis; focal necrosis of the liver; emacia- tion; ascariasis; trichuriasis.
File No. 1985: F. J. ;
Anatomic diagnosis: Beginning lobar pneumonia, right; typhoid enteritis; acute parenchymatous nephritis; acute parenchymatous degeneration of the heart and liver; calcareous nodule in the left lung; ascariasis.
30 The Philippine Journal of Science 1919
The above necropsy records show that no known treatment would have prevented the fatal outcome. Undoubtedly, these patients died of what are commonly known as “accidents of typhoid.”
Gay and Chickering,(11) in 1915, had 9 per cent mortality in fifty-three cases, treated with their vaccine; Gay,(9) in 1917, had 6.6 per cent mortality in ninety-eight cases. In my series the mortality is 10 per cent, after excluding the three hopeless cases. Ichikawa,(15) however, in 1914, had 12 per cent mor- tality in eighty-two cases; but his controls-showed 30 per cent mortality, while my controls showed 23.8 mortality. McWil- liams (34) has this to say about the rate of mortality:
The percentage mortality in itself offers but little evidence as to the danger or efficacy of the treatment, as it will necessarily vary according to whether only mild cases, only severe cases, or all types of cases are subjected to the injections. The highest death rate, 23 per cent., was observed by Paulicek. His patients were soldiers who had suffered from severe exposure in cold weather, and they died in most instances from a complicating pneumonia. The high mortality of 23 per cent. represents, he says, a reduction by 20 per cent. from what was obtained without the injection of vaccine. It has already been mentioned that the death rate in Ichikawa’s control cases was more than twice as high as in the treated cases.
Of far greater importance than the percentage mortality is the question as to how many, if any, of the deaths could be attributed directly to the
ion of the vaccine. Five cases (treated by Boral, by Csernel and
arton, by Lowy, Luksch and Wilhelm, and by Paulicek) showed intestinal hemorrhage following the injection and terminated fatally. One case (of Sladik and Kotlowski) resulted fatally from hemorrhage into the thyroid gland. One of Eggerth’s patients developed a hemorrhage from the lungs and died three hours after the injection. One of Biedl’s had hemorrhage from the nostrils before the intravenous injection of vaccine was given; after the treatment the hemorrhage recurred and could not be stopped.
~ CONTROLS
The fact is well known to all who have had experience with the disease that, strictly speaking, no two cases of typhoid fever are of equal severity. But this does not mean that we should disregard entirely the value of controls; for, although the results are not necessarily equal, yet, taking them as a whole, the factors concerned are minimized and the results thus obtained are approximate, if not exact.
By the term control, as used in this paper, I mean the classi- fication of typhoid patients into groups of cases showing a more or less equal degree of infection, as a basis of comparison with other groups of patients, similarly affected by the same disease but undergoing different kinds of therapy. That is to say, the
XIV, 1 Lantin: Treatment of Typhoid Fever 31
controls are grouped conjointly with the cases that are subjected to the intravenous treatment with sensitized vaccine.
These control cases were subjected to classical treatment, which consists in the application of general hygiene and care; the administration of light, nourishing food; the application of hydrotherapy, either cold or tepid; and absolute rest. As an accompaniment to this treatment the patient may be given cardiac stimulation, soda enemata (1.5 per cent solution) every other day, and occasional, small doses of urinary antiseptics. The patient may be given 1,000 cubic centimeters of proctocly- sis daily of normal saline solution and should be encouraged to drink plenty of water as an aid to disintoxication.
This series consists of twenty-one cases. Their clinical grouping is shown in Table VI.
TABLE V1.—Condition of patients before treatment.
Cases. Severe and toxic 6 Severe and nontoxic 11 Mild 4 Total 21
In the sixteen cases remaining after five deaths are excluded the average duration of the disease was 27.7 days, while in the cases treated with sensitized vaccine, as previously stated, it was 24.1 days. Gay,(10) in using similar treatment, found that the average duration of the disease was 27.6 days. McCrae, (33) in analyzing fifteen hundred cases of typhoid, found that the average duration was thirty-one days.
Complications—Out of these twenty-one cases there were eight cases that developed complications, two of which showed them on admission. Table VII shows the variety of the com- plications:
TABLE VII.—Complications in eight cases of typhoid fever.
Intestinal hemorrhage
Cases. Lobar pneumonia (present on admission) 2 Bronchopneumonia 3 Perforation : 8
Total
In connection with these complications, it is interesting to compare the complications that developed only during vaccine treatment with those that appeared in the controls as shown in Table VIII.
1623233
32 The Philippine Journal of Science 1919
TABLE VIII.—Complications in control cases.
Cases. Controls (after excluding 2 cases in which complications were present on admission) 6 Sensitized vaccine treatment 6
The above comparison differs somewhat from the results ob- tained by other investigators, such as Gay(9) and Waitz- felder,(48) who have claimed that vaccine therapy diminishes the incidence of complications. My results, however, are some- what similar to those of Whittington,(49) who found that well- controlled cases develop a smaller number of cases of compli- cations. The discrepancy between my observations and those of Whittington may be due to the fact that he observed a greater number of controls than I had available for treatment.
Mortality.—The rate of mortality is very discouraging, if not alarming. There were five deaths out of twenty-one cases, a mortality of 23.8 per cent. If we exclude the two cases that I considered hopeless on admission, the rate of mortality will be reduced to 14.3 per cent. Only two cases were autopsied out of five deaths, and the anatomic diagnoses show the following:
Anatomic diagnoses (autopsy findings of control cases).
File No. 1749: I. §. ) Anatomic diagnosis: Acute ulcerative enteritis (typhoid) ; suppurative peritonitis following perforation; acute parenchymatous degeneration
of the viscera; cardiac dilatation; oedema of the meninges. File No. 1834: B. C.
Anatomic diagnosis: Acute enteritis (typhoid), congestion, and begin- ning necrosis; acute splenitis; acute lymphadenitis, mesenteric; acute dilatation of the heart; acute parenchymatous nephritis; parenchymatous degeneration of the heart and liver ; focal necrosis of the liver; chronic caseous lymphadenitis, bronchial; chronic fibrous pulmonary tuberculosis; emphysema, interstitial; ascariasis.
Again, I have to state that the untreated control cases of Ichikawa(15) showed a mortality rate of 30 per cent in com-
parison with my mortality of 14.3 per cent after two hopeless cases were excluded.
SENSITIZED VACCINE ADMINISTERED INTRAMUSCULARLY
Early in 1911 Metchnikoff and Besredka (27) advocated the use of living sensitized typhoid vaccine intramuscularly for pro- phylactic purposes and claimed to have secured excellent results thereby. Followers of this school have adopted that practice and have even gone so far as to use this form of vaccine as a
XIV, 1 Lantin: Treatment of Typhoid Fever 33
therapeutic agent, and they have drawn others into the ranks. Among the leading investigators in this field, according to Gay . and .Chickering,(11). are Ardin-Delteil, Negre and Raynoud, Boinet, Delearde and Leborgne, Sable, Netter, Roques and Al- faro, Feistmantel, and Garbat.
In this series there were ten cases treated with sensitized typhoid vaccine intramuscularly, and the series was treated just after the series of cases treated intravenously with sensitized vaccine.
TABLE IX.—Condition of patients before treatment.
Severe and toxic Severe and nontoxic Mild
bet Q
Total
Mode of treatment.—The sensitized typhoid vaccine, as stated
previously, was administered intramuscularly. The dosage em-
ployed was from 250 to 1,000 millions every three or four days.
Gay advised 800 millions every other day and Garbat 500 millions
every five or six days. The results of this treatment upon the course of the disease are shown in Table X.
TABLE X.—Sensitized typhoid vaccine administered intramuscularly.
j Cases. Dey § | Dura- | Dura- Classification by results. Severe | severe Total. — peed 3 i povthed mild. | 224 |" and ment. | ent. toxic. toxic. ‘ Days. ; Days. AbOtte -sis e ee See eas 4 0 0 4 10 $.2| 13.2 Bene tee fe. Se as aa Ses 0 2 0 2 16 11.0) 27.0 Relatively unaffected .._-.-....---.--.- 0 1 0 1 11| 32.0} 43.0 PONG a er ee 8 Se ak meee nies Seu tens Deeg Cridias. 22) oe eee es ee te ee ee pe PERE aor) © einer Siar oie RR RSE See inp ee Ie mh Renae Mn as Oy Geren on bier ha! alert S ae eet PVerage oo a oo a a ee aes capes 27.7 x.
Thus, it may be seen that there were four abortive cases, all observed in the beginning of the second week, and all of them mild, in which the average duration of the disease was 13.2 days; two benefited cases, during the third week, both of the severe and nontoxic type, with twenty-seven days as the average dura- tion of the disease; and one relatively unaffected case of the same type as the benefited cases, with forty-three days as the average duration of the disease. The total average duration of
34 The Philippine Journal of Science 1919
the disease was 27.7 days. Fall of temperature by crisis was _ observed in only one case and fall by lysis in three cases, all in cases of the aborted type.
Symptomatology.—The intramuscular injections were not followed by the train of symptoms observed in the case of the intravenous injections. However, there was a slight rise of temperature, appearing in the majority of cases from twelve to twenty-four hours following injection, and rarely after this time. The temperature in such instances may fall by lysis and, very seldom, by crisis. During the course of the treatment it was observed that a mild reaction was necessary in each case to obtain the desired result.
Complications.—The complications are summarized in Table XI.
TABLE XI.—Complications before and during treatment.
Before | During treat- treat- ment. ment. Lobar p Moan tibia esta ebe sauces a 1 1 Bronchc Pp Bee ek anal eU ne dcwsesuskoudSececeuucccabescauee ee 0 1 OIRO Sa a a nie ty ec 0 0 NN aa rah an enh bea) Sees aE ve a 1 2
There were two cases that developed complications during the treatment, giving a rate of 20 per cent; one case was lobar pneumonia and the other bronchopneumonia.
Mortality.—The total mortality in these ten cases was three, a death rate of 30 per cent, which is exceedingly high. Ex- cluding two cases admitted in a very serious condition, the mortality rate would be 10 per cent. The deaths that occurred did not follow immediately after injection, but two days later. Only two cases were autopsied; the findings are shown below:
Autopsy findings (sensitized intramuscular treatment). File No. 1968: J. P.
Anatomic diagnosis: Typhoid enteritis (healing); acute parenchy- matous degeneration, viscera; beginning lobar pneumonia, right; chronic fibrous pleurisy ; oedema of the meninges,
File No. 1914: V. H. Anatomic diagnosis: Bilateral bronchopneumonia; typhoid enteritis
(healing) ; cardiac dilatation; acute parenchymatous degeneration, viscera; acute cholecystitis,
It will be seen, therefore, that the patients died of “typhoid accidents,”
XIV, 1 Lantin: Treatment of Typhoid Fever 85
Garbat(8) in his paper quotes the results obtained by some investigators who employed sensitized typhoid vaccine intramus- cularly, thus: Boinet (1913), 15 cases; Szecsy, 112 cases; and Garbat (1911-1912), 17 cases. All of these authors observed good results.
NONSENSITIZED, UNTREATED VACCINE, ADMINISTERED INTRAVENOUSLY
Following the report by Ichikawa(15) in 1914, on intravenous injection of sensitized typhoid vaccine in the treatment of typhoid fever, many investigators used his method, but they em- ployed a vaccine of the plain bacilli killed by heat. Among Ichikawa’s leading followers according to Gay and Chickering (11) are Thiroloix and Bardon, Kraus and Mazza, Kraus, Biedl, Csernel and Marton, Rhein, Reibmayr, Mazza, Holler, Lowy, Luksch and Wilhelm, Paulicek, Dithorn and Schultz, and McWilliams. All of these investigators observed beneficial re- sults following the use of this form of vaccine.
There were nine cases in this series treated with nonsen- sitized vaccine, administered intravenously. However, the patients in this series had been treated at a different time, following the treatment of the series that had undergone treat- ment by intramuscular injection of sensitized vaccine. The clinical grouping of these cases is shown in Table XII.
TABLE XII.—Condition of patients before treatmert.
Cases.
Severe and toxic 1 Severe and nontoxic 6 Mild 2 Total 9
The results of this treatment are illustrated in Table XIII.
TABLE XIII.—Nonsensitized vaccine administered intravenously.
Days | Dura tetas Classification by results. —— Gave Total. pee ty Lowney —< Mild. nee Fc ment. | ment. toxic Days. | Days. PI eae 2 3 0 5 11.8 8.9 | 15.1 Pencdhited 352 eee 0 3 0 3 15.3 9.6 | 24.9 Relatively unaffected <.:.....s<-2+2-<--|.--.---=|2--.5-]--3- +255 0 biccoctubieeepeecianeencds UAB visi cate ie Sax tewkcencake<|oenwinlawewceen 1 1 hicewexcctebeceweatenes sous UE re etiednnianneenrmweclareenree 5 Ge eal Pe eee Mee ee Tigi a cra keen denne dion ean nn amen o ne paenenees pie EDC, SERIE ORE: HY aS AVORERO ooo Ks Ef aie sens eae sounhueaas Con cee camealesemeees 20.0
36 The Philippine Journal of Science 1919
. As shown in Table XIII there were five aborted cases, ob- served during the second week of the disease, of which two were mild and three were severe and nontoxic, with an average dura- tion of the disease of 15.1 days. On the other hand there were three benefited cases, all of which were severe and nontoxic, with an average duration of 24.9 days. The total average duration for the aborted and benefited cases was twenty days, in contrast to 24.1 days, the total average duration for the cases treated with sensitized vaccine intravenously. The difference in results may be accounted for by the difference in the severity of the cases, the period of observation, and the relatively fewer cases in the series. An illustration of the abortive type is shown in the accompanying charts (figs. 5 and 6).
S| 5th day Cth day. 7th day 8th day. | 9thday y A.M. | A.M.| RM. A. M. EO AY REE A Te S| [2 6/02 6 /0ol6 /012\2 4 6 B 0122 4 6 8102 102 6 Ole 6 /0 be] +1 1}4 8 $ + Wiou 8 SL" <q g S| ~ “| S88) | | ig a N 40) 8 39 - (onmme rs Ney 38° — \ \ | d+o1d ct
Fic. 5. Temperature chart of J. A. Abortive type of typhoid fever, treated with nonsensi- tized typhoid vaccine intravenously.
2 9th day. 40 th day. ‘1 th day. (2 th day. AM | PM | AM, PM, A. M. PM | AM. | PM 26102 61012 6 \2 468 1012\2 46 8 10/2\2 4 6 19\2 6/0\2 6
Si] Hd
5 FH! g
Ss 3s &
=] } Bisiz
Pye MM SGSES ‘S
oO} \ o 39 fe 36° 0+0-0; 37° | Pro. ron ae Or Wr 36° é
Fic. 6. Temperature chart of C. G. Abortive type of typhoid fever, treated with nonsensi- tized typhoid vaccine intravenously.
XIV, 1 Lantin: Treatment of Typhoid Fever 387
Symptomatology.—The symptoms observed were similar to those that had been met with in the patients treated with sen- sitized vaccine.
Dosage.—Dithorn and Schultz used 70 to 300 million bacteria as their dosage, Miller and Lusk(29) used 200 millions, and McWilliams(34) used 250 to 500 millions. The doses used in this investigation range from 200 to 250 millions. Gay and Chickering(11) state that, if ,an overdose is administered, alarming or dangerous symptoms may supervene.
Complications.—There were three cases that had lobar pneu- monia as a complication before treatment was begun, and one developed intestinal hemorrhage three days after injection. Table XIV shows the number of cases and the kind of com- plication that developed.
TABLE XIV.—Complications before and during treatment.
Before | During treat- treat- ment. ment,
Lobar pneumonia..._.-....---------- -------- ---- ---- -----2-- 22-2 enn nnn nnn 3 0 Intestinal heemorrhage--.--.--------------------------------------------------- 0 al "Totand ns Sa ee en a sp a es wo tee cone an - ote 1
a Appeared three days after injection and recovered.
It will be seen in Table XIV that there was but one case in which the treatment might be suspected as having been the cause of intestinal hemorrhage, but there was not sufficient clinical evidence to support the suspicion. In this case the hsemorrhage did not appear until three days after the injection, while McWilliams(34) recorded in her paper five cases reported by Boral, by Csernel and Marton, by Léwy, by Luksch and Wilhelm, and by Paulicek, in which it was evident that intes- tinal hemorrhage, terminating fatally, followed the injection. One of Eggerth’s patients developed a hemorrhage from the lungs and died: three hours after the injection.
Mortality.—The mortality in nine cases is one, giving a mor- tality rate of 11.1 per cent. This case was deemed hopeless on admission, and autopsy findings indicate that the patient died
of the so-called “typhoid accidents.” Autopsy findings (nonsensitized intravenous treatment).
File No. 2302: P. N. He ae Anatomic diagnosis: Ulcerative enterocolitis, typhoid; acute splenitis;
acute lymphadenitis; typhoid; marked focal necrosis, liver; miliary tuberculosis, pleura; acute parenchymatous nephritis; parenchy-
matous degeneration of the heart.
38. The Philippine Journal of Science 1919
*
PEPTONE
Nolf (36) in February, 1917, published his extended observa- tions made in France during the war, on parenteral injection of peptone solution in the treatment of infectious diseases in general. His experience has shown the efficacy of this treatment in typhoid fever, in the consequent “‘warding off of intestinal hemorrhage from reduced coagulating power of the blood.” He employed 10 cubic centimeters of a 5 per cent solution intramus- cularly in the gluteal region. Intravenous injection should be given slowly and with caution. I was able to apply this form of treatment intramuscularly in a very limited number of cases that were admitted at the end of the epidemic, when morbidity was reduced to the minimum. This series consists of five cases, and the relative severity of the infection in each patient is illus- trated in Table XV.
TABLE XV.—Condition of patients on admission.
Cases. Severe and toxic 0 Severe and nontoxic 2 Mild 3 Total 5
Following the injection of 10 cubic centimeters of a 5 per cent sterile peptone solution every two or three days two mild cases aborted in the beginning of the second week of the disease, with 12.5 days as the average duration of the disease. Three cases were benefited; of these, one was mild and two were of the severe and nontoxic type, with twenty-two days as the average duration of the disease. The total average duration of the disease in this group is 17.2 days. There were but two cases of defervescence by lysis, and none showed a temperature fall by crisis. A summary of the results of the treatment is shown in Table XVI.
TABLE XVI.—Peptone injection.
Cases, ss Days Dura- | Dura- Classification by results. Severe Savane Total. Pests a oy Mild. | 294 | and ment, | teat- | dis. none | toxic. ment. | ease Aborted 25 2 0 0 2 8.5 zh ny ; Benetited o.oo 1 2 0 3 12.0 10 | 22.0 Relatively unaffected.........._.....__ 0 0 0 de SENOS, MARC AG I By etapa ee oe ee i Mcgee Wong Seen epee re eee QB oo ons won cnaneakorecgucafemermed. Ros ae Le OC hs ee ae sonia ener eI NE EEN “SONY Gore ps ee : i “172,
XIV,1 Lantin: Treatment of Typhoid Fever 39
Symptomatology.—The symptoms observed were: Slight rise in temperature, supervening from twelve to twenty-four hours after treatment and rarely after forty-eight hours; slight leu- cocytosis after twenty-four hours; and slight alterations of subjective symptoms. The temperature may assume the lytic, remittent, or intermittent type. An example of the lytic type of temperature curve is shown in fig. 7.
NS 9th day. 10 th day. //th day. /2 th day. S| A. M.| 2M. | AM | RM | AML PML AMR Sl2 6/12 6 /0|2 6 /0\2 6 0|2 6 /0|2 6 /0\2 6 10\2 6 10
Fe RS
Sis | RI] OR SP ess o S| Se iss |S] i 1b S| |S) 8 =» | 1S + $ =) § S S Te Pe 8] iss | Si is pepe
85 S S BES ES
DS] =
4 {Sis} | I | IS See 40 [oi oF — 39 s No. Seog Rp 58 J A Ld SS ‘ ES: db IN PO N y ae,
Fic. 7. Temperature chart of F. V. Abortive type of typhoid fever, treated with peptone intramuscularly.
Complications.—Complications observed during the treatment
were one case of acute bronchitis and one case of intestinal
hemorrhage (hemorrhage present at admission). Mortality—As these cases were all admitted when the epi-
demic was in its terminal period and morbidity not at its maxi- mum, none resulted fatally.
MILK
Saxl(45) in 1916 successfully employed sterile milk in typhoid fever, administered intramuscularly. In fact, it is commonly used in Germany. The principle involved in this treatment is the introduction of a heterogonous protein substance, which con- stitutes a considerable portion of the milk.
40 The Philippine Journal of Science 1919
The dosage that I have employed was from 10 to 20 cubic centimeters intramuscularly injected in the gluteal region.
Hight cases were treated with milk, all of which were ad- mitted into the hospital when the morbidity of the epidemic was declining.
The condition of the respective patients on admission is shown in Table XVII.
TABLE XVII.—Condition of patients on admission.
Cases. Severe and toxic 2 Severe and nontoxic 4 Mild 2 Total 8
The results of the treatment in this series are summarized in Table XVIII.
TABLE XVIII.—Milk injection.
Cases. : ' Rare Dura-| Dura- Classification by results. Severe Severs Total. treat- | tion of — of Mild, —_ and ment. ne: oe x toxic, | toxic. Days. | Days. ADOPEN oo ee es ee ae 2 0 0 2 8 4.5) 12.6 ac cis Me ER UE a: dh eS 0 2 i) 2 9 13.0} 22.0 Relatively unaffected _________ 0 2 0 2 11 17.5 | 28.5 Denis ce ee ee 0 0 2 bs Seater ac a a is wate! alae ee en MSE ORIN pines Hae ee paces UO aie bees CE PT On ER a ERNE SER ee ae Beate tas x arn dapat ee CPPS OREN Ie UNAS, Gee baes OF cece owas els es ee udhlo-yiceas Seakicer pee ren nthe RUNES BBG CS EES aera 21.0
It will be seen that only two mild cases aborted during the second week of the disease, with an average duration of the disease of 12.5 days; two of the severe and nontoxic type were benefited during the second week of the disease, with twenty- two days as the average duration of the disease; and two cases of the severe and nontoxic type were unaffected, with 28.5 days as the average duration of the disease. The total average duration was twenty-one days. There were two cases of tem- perature fall by lysis, and two that showed an elevation of tem- perature. The latter two were observed in connection with the formation of an abscess in the gluteal region in each case, as
XIV, 1 Lantin: Treatment of Typhoid Fever Al
the result of imperfect sterilization of the milk used. Upon evacuation of the abscess the temperature completely subsided after twenty-four hours. Of all the injections made, only these two cases developed such abscess formations. The accompany- ing chart shows the effect of the treatment (fig. 8).
Wy. th day. | tein day, | ith 14th day, | 0th day | lth day | 17th doy | 18th day | 19th doy ~ TA.MIP MA |A-MIE WA. MIP ALAM IP. MIA. MIP MIAME MIA MP MA MP. MIAMI? 2EM26M2 EM? EUILEWMZ6W2 6262 6 0126 W2 6 WiI2 6 2 6 2 6 W126 2 6 M2 EWi2 6 Wi2
TAC AM
Fempernars| 2
e 3
t 2
ak ek OE A Centigrade fora A= — |%
Fic. 8. Temperature chart of E. A. Illustrating the effect of intramuscular injection of milk.
Symptomatology—The symptoms observed were: A slight rise of temperature; pain and tenderness in the gluteal region; slight leucocytosis; and gradual amelioration of subjective symptoms. The temperature may become lytic, remittent, or intermittent. An example of the benefited type in which the temperature became remittent, finally falling to normal, is illus- trated in the accompanying temperature record.
Complications.—The complications that were observed are shown in Table XIX:
TABLE XIX.—Complications before and during treatment.
Before | During ‘treat- treat- ment. ment.
Lobar p ee eh ence Uae PACE EL bw e adi cowena ee see epeeee ise Intestinal heemorrhage.---------------------------- -------------------------- Abscess of the buttocks__..---------------------- -----------------------------
ni, o = = i)
8 Hemorrhage appeared five days after injection and the patient died.
Table XIX shows that four cases exhibiting complications were observed during the treatment, of which one case was lobar ~ pneumonia, one case was intestinal hemorrhage, and two cases had abscess in the buttocks accounted for by improper sterili- zation of the milk-used.
Mortality.—There were two deaths out of eight cases, giving a mortality rate of 25 per cent. One of these cases that died
42 The Philippine Journal of Science 1919
was delirious and semiconscious, from the time of admission up to death. Autopsy findings of these two cases are as follows:
Autopsy findings (milk injection).
File No. 2662: S. L. Anatomic diagnosis: Acute ulcerative enteritis with hemorrhage (typhoid); acute splenitis and lymphadenitis (mesenteric); acute
eardiac dilatation; acute parenchymatous degeneration of the viscera. File No. 100: M. C.
Anatomic diagnosis: Ulcerative enteritis (healing typhoid) ; intestinal hemorrhage; subacute splenitis; dilatation of the heart; broncho- pneumonia (hypostatic); suppurative nephritis; acute myocarditis; parenchymatous degeneration of the liver; fibroma, left kidney.
The above necropsy records show that the patients died of complications.
COLLOIDAL GOLD INJECTED INTRAVENOUSLY
Colloidal gold, or colibiase as it is sometimes called, has been used extensively by French clinicians for a variety of infectious diseases, such as typhoid fever. Among the leading clinicians following this method, according to Gay,(9) are: Letulle and Mage(25) in 1914, Gay in 1915, Barachon in 1916, Labbe and Mausand in 1916, and Delbet in 1916.
A series of fifteen patients was treated intravenously with colloidal gold in connection with this study. This treatment was carried out when the morbidity of the epidemic was going down. The clinical grouping of the cases is given in Table XX.
TABLE XX.—Condition of patients.
Cases, Severe and toxic 5 Severe and nontoxic 4 Mild 3 Total 15
Dosage.—The dose employed by Letulle and Mage(25) in con- nection with their forty-two cases ranged from 1 to 2.5 cubic centimeters intravenously, 1 cubic centimeter for mild cases and 2.5 cubic centimeters for severe cases. The dose administered in my series was from 0.5 to 5 cubic centimeters intravenously, depending upon the severity of the case. In the majority of instances, 2 to 3 cubic centimeters was the initia] dose.
The results of the treatment are shown in Table XXIJ.
ee aes Lantin: Treatment of Typhoid Fever 43
TABLE XXI.—Colloidal gold injected intravenously.
Cases. Days | Dura- ea Classification by results. Severe | govere, Total. = tale tion of Mild. = and ment. | ment. (1!8ease- toxic. a Days. | Days. Retver bork sete ins per tera esa 3 2 0 5 6.6 4.2} 10.8 THROU oc ea ees 0 5 0 5 10.8 11.4|. 22.2 Relatively unaffected -..-.....---.----- 0 0 3 3 13.0 20.8 | 33.3 POGUDEN oe a as eg ese cl - sepe ene ne 0 0 2 Bo sc ce gs loncanessagukedan MD et Pak Bok ok eae | pecdiunl sau onumdt ewes ie i SEA, POE DNs eat CoE R GES (EO Rie RS Be Re cn oe ERs alee oR eniny SNE Me 3 Paap eae 7 Mere ase Og PERE Ret eeaee, Deer aves TROURIRG 550 oe. A PETE iad Om eS ie apy, mae eee: BD a Se ae FAN EE ie RiWOrURE oon oe eae acse Peeccaneupnea- piped Se ae es eee Pen 2.1
As shown above, the five aborted cases, three of which were mild and two severe and nontoxic, were all observed during the first week of the disease and had an average duration of disease of 10.8 days; the five benefited cases during the second week, all of which were severe and nontoxic, had an average duration of the disease of 22.2 days; the three relatively un- affected cases, all of which were severe and toxic, had an aver- age duration of the disease of 33.3 days. The total average duration of the disease was 22.1 days. In one of the cases tem- perature fall by crisis was observed, in four cases decline by lysis was noted, and in only one case did a relapse develop. The charts, figs. 9 and 10, show the effect of the treatment.
3d. day. 4th day. Sth. day. 6th. day. AMR at Ae fa tt: A. M. PM |A™M. PM. Wie 6/02 6 | 2 6 Wl2 4 6 8 1012|2 + 6 8 10/2 6 10|2 & 10/2 6 /012 > 3 vel a e Xs ) 31S x = w Si | [ays ais] ja |s 8 S > do “apa es ~ S Si] Ss] 1 8S 8 & 8 : SG Sil iG} |S =I 8g A i PPro Fo! 38% i? 0 Ol | OO 37° -O Ot O
Fic. 9. Temperature chart of J. R. Abortive type of typhoid fever, treated with colloidal gold intravenously. Widal negative till discharge.
day. Sth day. 9th Jay. /0th day. Mth day. 42 th day. 3 th day. AT ACMA 7 a 5 a 1A.MIE MIA MIP MIA.MSNP M.. 26 10|\2 6 10\2 6 10\2 6 IW2 6 10\2,6 10
> = Do) = h = NP siX Ny ak sik NS of? sik Nin n siz Mp n six Nh n sk Shy % MaRS
8, Centigrade Widal = PSec.intravenous —|\%
NS a hd N SN 37 Do.
*#Ic. 10. Temperature chart of I. R. Showing benefited type of typhoid fever, treated with colloidal gold intravenously.
Symptomatology.—Letulle described the symptoms that ap- peared after the intravenous injection as consisting of a tem- porary rise in temperature preceded by chills, occurring from fifteen to forty minutes after injection, and followed by fall in temperature, sweats, general weakness, and alleviation of subjective symptoms. With my limited opportunities for ob- servation, so far, I can only say that none of my cases developed chills. There is the possible exception of one patient who felt a slight sensation of chilliness, although his temperature showed a slight rise. Whether this difference of observation is due to racial insusceptibility of Filipino patients to the after effects of the treatment or whether the preparation on hand was defective are matters for future investigation. .
Other symptoms observed were slight leucocytosis, temper- ature fall by lysis, remitting or intermitting temperature, and, rarely, fall by crisis. On the following day amelioration of the subjective symptoms may be marked.
Contraindications.—Letulle does not believe that delirium and high fever, tachycardia, small pulse, or albuminuria are contra- indications for the intravenous injection. According to him the kidney continues to function well, for polyuria appears after injection. He observed neither intestinal hemorrhage nor per- foration.
It is not improbable that nephritis may be produced after a long-continued use of this preparation, because metals generally have an irritating effect upon the renal epithelium. This con- ception is supported by the experiment undertaken by Schébl in which he found marked nephritis in the kidneys of animals
experimented upon with intravenous injection of colloidal silver preparation.
* Chief of the serum section of the Philippine Bureau of Science.
XIV, Lantin: Treatment of Typhoid Fever 45
In conclusion, Letulle has stated that this preparation is anti- thermic, antitoxic, and without danger to the patient. He bases his conclusions on the disappearance of typhoid symptoms such as stupor, etc.
Complications.—The complications observed during the treat- ment are shown in Table XXII.
TABLE XXII.—Complications before and during treatment.
Lobar pn@imonitisss a5 cocel ss ech eked 3s id netEbeeNeE ietiewt 1 1 Intestinal h rears Se Se ge Be 2 Sl aieatnaaenbinna sus 0 a2 AE oi eg na ok aoa dan CebL ui ps uwasddadiade dkwonWaspucsedns 1 3
4 One case developed two days after injection and the other six days after injection.
We see that there were three cases showing complications during the treatment, two of which were of intestinal hzemor- rhage and one of lobar pneumonia. The fact that the cases of hemorrhage did not appear early—that is, not until after two days following the injection—seems to show that the treatment did not induce this complication. The proportion of complica- tions during the treatment of the series was found to be 20 per cent.
Mortality.—Out of fifteen cases in this series there were two deaths, a mortality rate of 13.3 per cent. Excluding one hope- less case, the mortality rate was 6.6 per cent. Autopsy findings of the two cases that were autopsied are shown as follows:
Autopsies (colloidal gold treatment).
File No. 2682: A. C. Anatomic diagnosis: Lobar pneumonia; typhoid enteritis; parenchy- matous degeneration of the viscera. File No. 2603: H. G. Anatomic diagnosis: Ulcerative enteritis, typhoid, healing; subacute splenitis; focal necrosis of the liver; chronic parenchymatous nephritis; chronic suppurative bronchitis; cloudy swelling of the liver and heart; trichuriasis; chronic pleurisy; emaciation.
Undoubtedly the two fatalities resulted from complications. DISCUSSION . SPECIFICITY OF THE TREATMENT
Vaccine therapy has been studied extensively during recent years. The practical application of this biologic principle to the therapy of typhoid fever has its clue in the fundamental
46 The Philippine Journal of Science 1919
phenomena of Ehrlich’s side-chain theory. The undoubted success of prophylactic vaccine seemingly has given rise to un- restrained enthusiasm on the part of early investigators and has lead them to advocate its use for therapeutic purposes. This treatment, therefore, is the outcome of conscientious study in immunology and it is not a surprise that its followers should approach the question from that point of view.
Early in the history of vaccine therapy, Jenner(16) discovered the efficacy of the treatment. Fraenkel(7) employed it thera- peutically for typhoid fever with good results. Wright(50) has advocated and emphazied the specificity of its action. Waitz- felder(48) has advanced the view that the treatment is “logical, scientific, and exact. It measures up to and beyond the expectant plan of treatment, the one in present use, in that it reduces mortality and shortens the period of illness.” Rodet (41) em- ployed immune typhoid serum injected intravenously in typhoid cases with excellent results. Ichikawa(15) used the intravenous injection of living sensitized typhoid bacilli with excellent re- sults. Gay(9) and Garbat(8) in using sensitized vaccine have upheld the specific theory.
Mechanism of cure.—To explain the exact mechanism of cure with this form of treatment is exceedingly difficult, if not im- possible. However, the interpretation of the mechanism of the action of vaccine has been given most serious consideration by other investigators, who have advanced hypotheses which we may review.
Thus, Garbat(8) believes that the curative effect of vaccine is due to the production of antiendotoxins as the result of stimulation by endotoxins that had been liberated into the blood- stream after the complement in the blood had combined with the bacilli. Ichikawa,(15) on the other hand, is inclined to the supposition that in the case of intravenous injection followed by chill, rise of temperature, and then crisis, we have phenomena of anaphylaxis, followed by antianaphylaxis, Gay and Chicker- ing (11) believe that the cure is due to specific hyperleucocytosis and increased formation of antibodies in the blood circulation. Koranyi(20) has observed increased opsonic index in the blood after vaccine injection.
NONSPECIFICITY OF THE TREATMENT It is the tendency among workers along these lines to interpret the complex action of vaccine therapy through phases of im-
munology and the specificity of its action. The Specific theory has been regarded by the dissenters as untenable,
XIV, 1 Lantin: Treatment of Typhoid Fever 47
Rumpf (43) observed very early the nonspecificity of the treat- ment. By injecting Bacillus pyocyaneus in typhoid he could procure results quite as favorable as those secured by Fraenkel after the injection of typhoid bacilli. Kraus(21) used colon vaccine intravenously in similar cases, and gained equally good results. On the other hand, Kraus(21) used typhoid vaccine in cases of puerperal infections with similarly beneficial results. Even Ichikawa(15) found that his paratyphoid patients were benefited by the injection of typhoid vaccine. Furthermore, I have observed that the use of intravenous injections of plain killed typhoid vaccine in any form of arthritis produced remark- able results in the majority of cases. This is in agreement with the observations of Miller(28) and Thomas. (47)
Ludke, (26) in accordance with his view that bacteria consti- tute nothing more than a foreign protein in the animal economy of the host, employed another kind of protein of nonbacterial origin. He used deutero-albumose in typhoid, also with good results. Miller and Lusk(29) used 1 to 2 cubic centimeters of a 4 per cent solution of proteose intravenously in typhoid and ob- served similarly good results; 20 per cent of their cases so in- jected recovered by crisis after a single injection. Nolf(86) noted beneficial results in the use of peptone solution, injected either intravenously or intramuscularly. Sax! (44) successfully treated typhoid patients by intramuscular injection of sterile milk. In this study both peptone solution and sterile milk have been used by me with success.
There is evidence, however, that foreign protein is not the only substance used successfully in combating the disease. Thus Letulle and Mage,(25) Gay,(10) and Labbe(23) employed col- loidal-gold preparations with good results. In this investigation colloidal gold was also used, and satisfactory results were ob- served; as may be seen, 20 per cent of the cases in my series aborted. Mitlander(30) used salt solution intravenously in three hundred cases of typhoid fever, preceded intravenously by 1 cubic centimeter of 20 per cent caffein and 10 per cent camphor, and marked improvement followed. ;
Mechanism of cure.—Investigators in other fields have ques- tioned the specificity of vaccine therapy, a claim which they declare to be without foundation. To attack a disease with its own weapon, so to speak, seems rather paradoxical. For, then, this question has been asked—and it still remains without a satis- factory answer: Are we justified, in acute infectious disease, in introducing in any manner into a host more of the same toxin
16238283———4
48 The Philippine Journal of Science 1919
from the effects of which he is already suffering? The view that there could be no possible stimulation of antibodies in a patient already suffering from acute infection with the typhoid organism has been given much thought in the effort to explain the me- chanism of abortive cures, because it has been observed that there is no immediate change or increased concentration of anti- bodies in the patient after injection of vaccine.(18) In the case of pneumonia Cole,(4) at least, has not been able to produce immunity in animals rapidly enough to be of therapeutic value within six or seven days. The observations of other writers that there is a slight increase of Widal titer have been questioned on the ground that the Wright(28) opsonic index seems now- adays to be an unreliable guide, for the simple reason that the immunologist has no better method for determining immune body formation.
It has been observed in experimental work on animals that there is increased formation of nonspecific ferments, such as protease and lipase.(19) It is believed the protease has no action on bacteria, but that it hydrolyzes toxic protein into simpler and nontoxic substances, and that the lipase becomes lipoprotein against organisms in the final analysis. Whether the thera- peutic application of other substances would mobilize the same nonspecific antiferments remains to be seen, although it is not improbable that such a thing may occur. That all improve- ments observed in bacteriotherapy might be wholly due to such Specific action is, in my opinion, doubtful; because the frequent occurrence of relapses forms one of the objections to the belief that bacteriotherapy is specific.
Having set forth the two conflicting ideas in regard to the probable mechanism of cure, I am led to believe that the exact details of its mechanism are not fully known, and that in order to work out this problem a thorough codperation between clinicians and laboratory workers is very necessary to allow justifiable interpretations of results.
Now, it might be asked, What form of therapy should be recommended in treating typhoid fever with the methods em- ployed in this investigation? This is an exceedingly difficult, if not impossible, question to answer. It should be remembered that, in order to answer it satisfactorily, all the cases in each series should be placed under similar circumstances; that is, each series should consist of the same number of patients, who should be of the same sex and approximate age, and treatment should be administered simultaneously ; the disease in each case should
XIV,1 Lantin: Treatment of Typhoid Fever 49
be of equal degree of severity and occur during the same period of epidemic, and the same season of the year. When a physi- cian has the opportunity to handle a large number of cases at one time, and observe as closely as possible the factors enume- rated above, then and only then will a definite statement seem warranted. When laboring as I have done, under unfavorable circumstances, in which many of the ideal and necessary factors could not be obtained, to recommend a particular treatment as being the best would be premature, and unfair both to the ex- pounders of the several systems of therapy and to the treatment itself. There are, however, some clinical grounds for maintain- ing the view that any form of treatment will have beneficial effects, provided a moderate reaction can be produced.
Let me lay emphasis on the principle of the early application of the treatment. The patients respond better during the early stage of the disease. In advanced cases the treatment is seldom ‘productive of good results.
SUMMARY AND CONCLUSIONS
For a period of seven months, extending from August, 1917, to February, 1918, ninety-eight cases of typhoid fever were admitted to the medical department in the Philippine General Hospital. Twenty additional cases were admitted during that period, but these were not included in the present paper, because they were already either convalescent or in a dying condition on admission. These ninety-eight cases were all Filipinos, sixty- five males and thirty-three females, ranging in age from 14 years up. The majority of the cases belonged to the working class and, as a rule, exhibited low powers of resistance, conse- quent on “their mode of life, under-development, and limited diet.” The mortality rate in these ninety-eight cases is 19.38 per cent; but, excluding the hopeless cases, the death rate was 10.22 per cent.
These cases were classified according to their severity, the cases being grouped in series. Each series naturally comprised an unequal number of patients, was treated at different periods of the epidemic, and received different kinds of treatment.
The treatment of the cases has been carried under two general groups; namely, (a) treatment with foreign protein, which in- eludes sensitized and nonsensitized vaccine, peptone, and milk; (b) treatment with colloidal preparation, such as colloidal gold.
Table XXIII shows graphically the comparative results of the different treatments.
50 The Philippine Journal of Science ms
TABLE XXIII.—Comparative results of different treatmenis.
| | Total ; Mode of administra- | Pa- | Sverage , Variety of treatment. Ae see tents. | a Deaths. | ease PS aa cota or ae ad ee Days. |Number.' Per cent. Sensitized vaccine .._____.______. Intramuscular__-_____- 30 | 24,1 6 20 IASNT A a ee Contes oo 21 | 27.7 5 23.8 Sensitized vaccine _._.__.________ Intramuscular____.._- 10 27.7 3 30 Nonsensitized vaccine -.....____. Intravenous ___.._.._. 9 | 20.0 1 a ee Penne cst oh ests Sle Intramuscular_______. 5 | Py a 0 0 POA Se pu ecenomec see oe ea CSS Saga a ETC 8 | 21.0 2 25 (onoMsl wold’. 23h a Intravenous __________ 15 | 22.0 2 13.3 SORE Sader thn torso as bek ae ee ee 98 | oe ok | a lanpake eae
In the investigation here discussed I have employed some of the treatments that I believe are stamped with the march of progress. After conscientious deliberation of the observations gained, both from my limited personal experience and from the experiences of other investigators in this field, I am inclined to believe that the nonspecific theory with regard to the action of vaccine as used in this investigation seems plausible, but that the exact details of the mechanism of action of each kind of treatment administered is not yet fully understood. However, it has been observed that a moderate reaction, following the administration of any of the treatments discussed, produced beneficial effects.
ACKNOWLEDGMENTS
To Prof. Ariston Bautista, chief of the department of medicine, University of the Philippines, I acknowledge sincerely my high obligations for financing this investigation, and placing at my disposal all the material available in the department; also to Drs. Luis Guerrero, A. G. Sison, and Elias Domingo, for their encouragement in this work: to Prof. F. G. Haughwout and Dr. Otto Schébl, for their help and suggestion; to my as- sociates, Drs. Facundo Esquivel and Trinidad Banuelos, for their valuable codperation; to Dr. Jose Hilario, for the preparation of the sensitized vaccine; to Dr. Ricardo Fernandez, for the translation of the French literature on the subject; and finally to the department of pathology whose autopsy records I have been permitted to use in this study.
XIV,1 Lantin: Treatment of Typhoid Fever 5l
PRwWnN ee
-
REFERENCES
. BESREDKA. Cited by McWilliams (84).
_ Ceci, R. L. Journ. Inf. Dis. (1915), 16, 26.
. CHAMBERLAIN, W. P. Philip. Journ. Sci., Sec. B (1911), 6, 317.
. Cots, R. I. Trans. Congr. Am. Phys. & Surg. for 1916. The Tuttle,
Morehouse and Taylor Co., New Haven, Conn. (1917), 10, 138.
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edited with additions by W. Osler. W. B. Saunders Co., Philadelphia (1902), 383.
_ DITHORN and ScHULTZ. Cited by Jobling, Petersen and Eggstein (17). . FRAENKEL. Cited by Hektoen (13).
. Garpat, A. L. Med. Rec. (1916), 90, 1145.
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. IpeM. Cited by Gay (9).
. Gay, F. P., and CHICKERING, H. T. Arch. Int. Med. (1916), 17, 303.
GuTIERREZ, P. Philip. Journ. Sci., Sec. B (1914), 9, 375.
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_ IcHIKAWA. Cited by McWilliams (34).
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(1915), 22, 603.
_Ipem. Journ. Am. Med. Assoc. (1915), 65, 515.
_ Ipem. Ibid. (1916), 66, 1753.
. Koranyi. Cited by Gay (9).
. Kraus. Cited by Jobling, Petersen and Eggstein (17). ; _ KRUMBHAAR and RICHARDSON. Cited by Gay (9).
. LABBE. Cited by Gay (9).
. LEAKE, J. P. Journ. Am. Med. Assoc. (1917), 69, 631.
LETULLE,’M. M., and MAGE, M. Bull. Acad. Med. (1914), 72, 42.
_ LupKE. Cited by Miller (28).
. METCHNIKOFF and BESREDKA. Cited by Gay and Chickering (11).
. Miter, J. L. Journ. Am. Med. Assoc. (1917), 69, 765.
. Mruuer, J. L., and LUSK, F. B. Journ. Am. Med. Assoc. (1916), 66,
1765.
_ MitLaANpeR. Abstracted in Journ. Am. Med. Assoc. (1916), 66, 1321. . McCrag, T. Osler’s System of Medicine. Lea Brothers & Co., Phila-
delphia and New York (1907), 2, 207.
. IpeM. Cited by Gay (9). _ Ipem. Cited by Gay and Chickering (11)._ _ McWituiams, H. I. Annual Report of the Health Officer of the Port
of New York. Albany (1916), 98.
. Nicuots, H. J. Journ. Exp. Med. (1915), 22, 780. _ Nour, P. Abstracted in Journ. Am. Med. Assoc. (1917), 68, 1349. . Oster, W. The Principles and Practice of Medicine. D. Appleton
and Company, 8th ed. (1914), 38.
_ Perruscuy. Cited by Gay and Chickering (11)... . QuapRONE. Cited by Gay and Chickering (11).
52
40. 41. 42, 43. 44, 45. 46. 47. 48. 49.
The Philippine Journal of Science
ROBERTSON, W. E. WN. Y. Med. Journ. (1916), 103, 777.
RopeT, A., and LEGRIFFOUL. Presse Medicale, Paris (1910), 18, 969. Rocers. Cited by Gutierrez (12).
Rumpr. Cited by Miller (28).
SAXxL. Cited by Miller (28).
IpEM. Cited by Miller and Lusk (29).
SLADEK and KotLowsky. Cited by Jobling, Petersen and Eggstein (17). THomas, H. B. Journ. Am. Med. Assoc. (1917), 69, 407. WAITZFELDER, E. N.Y. Med. Journ. (1916), 103, 407.
WHITTINGTON, T. H. Lancet (1916), 1, 759.
50. WRIGHT. Cited by Jobling, Petersen and Eggstein (17).
|
Pig? Ak 2.
3.
10.
ILLUSTRATIONS
TEXT FIGURES
Temperature chart of B. Y. Abortive type of typhoid fever, treated with sensitized typhoid vaccine intravenously.
Temperature chart of E. N. Benefited type of typhoid fever, treated with sensitized typhoid vaccine intravenously.
Temperature chart of M. L. Benefited type of typhoid fever, treated with sensitized typhoid vaccine intravenously.
. Temperature chart of N. C. Benefited type of typhoid fever,
treated with sensitized typhoid vaccine intravenously.
. Temperature chart of J. A. Abortive type of typhoid fever,
treated with nonsensitized typhoid vaccine intravenously.
. Temperature chart of C. G. Abortive type of typhoid fever,
treated with nonsensitized typhoid vaccine intravenously.
. Temperature chart of F. Vv. Abortive type of typhoid fever,
treated with peptone intramuscularly.
. Temperature chart of E. A. Illustrating the effect of intramus-
cular injection of milk.
. Temperature chart of J. R. Abortive type of typhoid fever,
treated with colloidal gold intravenously. Widal negative till discharge. Temperature chart of I. R. Showing benefited type of typhoid fever, treated with colloidal gold intravenously. 53
THE VALIDITY OF THE NAME DISCOMYCES FOR THE GENUS OF FUNGI VARIOUSLY CALLED ACTINO- ‘“MYCES, STREPTOTHRIX, AND NOCARDIA
By E. D. MERRILL and H. W. WanbrE
(From the Botanical and Bacteriological Sections of the Biological Labora- tory, Bureau of Science, Manila)
The nomenclature of the group of fungi the pathogenic mem- bers of which produce the various actinomycoses, so-called, has been the subject of a confusion that resulted from an unusual combination of circumstances. For some time it was a moot question whether the organisms were of bacterial or of fungous nature, in part because of erroneous conceptions of their mor- phology, which is complex and variable, and differs widely in different strains; even yet opinions differ as to whether or not the forms involved should be included in a single genus. One of the types, a saprophyte, Streptothrix foersteri Cohn, was for a time erroneously included in a genus of the higher bacteria, while the first pathogenic species described, Actinomyces bovis Harz, having been recognized as a fungus, was given a different generic name. The question was further complicated by the fact that both names had long before been employed for entirely different organisms. Since then some authors have held one invalid, some the other, and some have rejected both. Other names have been misapplied from time to time, while new ones have been proposed, the list now including a total of ten.
As is too frequently the case, the systematist and the pathol- ogist have tended to ignore the work and the viewpoint of one another. Medical writers, who almost exclusively have been con- cerned with the study of these organisms and consequently the use of their names, have been.very prone to choose these from the viewpoint of convenience and local custom rather than to recognize and adhere to the rules of nomenclature by which modern biologists are bound. On the other hand, botanists have overlooked or ignored—and they still do this—names and de- scriptions that have, in sincerity but without the formality cus- tomary with themselves, been published by medical writers. It is to consider the matter from both viewpoints in an effort to determine the actually correct designation that we have collabor- ated in a review of the vicissitudes of nomenclature that this
group has undergone. e
56 The Philippine Journal of Science 1919
HISTORICAL
The phase of the confusion in which the characteristic of true branching in these organisms was not appreciated began in 1875, when Cohn(18) described, among others, two organisms that he made the types of new genera. One, which he named Clado- thriz dichotoma, a colorless, filamentous plant found abundantly in water containing decomposing alge, was characterized by a false branching that he compared to that of certain alge; the other, which, apparently in ignorance of Corda’s(19) previous use of the same generic name, he called Streptothrix foersteri, was a branching filamentous organism said to have been found first by Graefe and then by Foerster in concretions in the lachrymal canal of man and classified by Waldeyer as Leptothrix buccalis. Cohn did not accept this conclusion, the mode of branching sug- gesting the mycelium of fungi. It has been pointed out by Sauvageau and Radais(56) that the distinction between his Cladothrix and Streptothrix was so clear to Cohn that in the text he did not even compare them; furthermore, that his illus- trations of them are quite distinct. They quote his diagnoses:
Cladothriz—n. g. filamenta leptothricoidea tenerrima, achroa, non ar- ticulata, stricta vel subundulata, pseudo-dichotoma.
Streptothriz—n. g. filamenta leptothricoidea tenerrima, achroa, non ar- ticulata vel anguste spiralia, parce ramosa.
In his summary, howevers Cohn did not clearly differentiate them. According to Migula(44) he put them together among organisms showing false branching, although indicating uncer- tainty as to Streptothriz by an interrogation point:
Zellfaden durch falsche Astbildung verzweigt, Faden cylindrisch, farblos—Cladothrix Cohn. Streptothria?
Cohn’s later understanding of the morphology of the latter is evident from Israel’s article cited below. However, it is hardly to be suspected from this arrangement that, as is now generally recognized, the dividing line between the higher bacteria and the lower fungi separates these two genera.
Bollinger, in 1876, demonstrated the fungous nature of the granules, or “drusen,” from the lumpy jaw of cattle. Attempts at cultivation and inoculation had been without result. In the following year(10) he published a description in which he stated - that Harz, to whom he had submitted fresh material, had con- cluded that the ray fungus (Strahlenpilz) belonged to the mold fungi and that it was related to Botrytis, Monosporium, and Polyactis; the name Actinomyces bovis was proposed for it.
xiv,1 Merrill and Wade: The Validity of Discomyces 57
Rivolta, (53) in 1878, changed the generic name to Discomyces. After amplifying the descriptions of the granules (corpuscoli discoidi) that he had made in 1868 and 1875, he said in part:
E vero chi i corpuscoli discoidi compressi si risolvono in pennelli od in ventagli fatti di rami e ramoscelli, mar percio non si ponno dire raggiati. Questa parola in storia naturale ha un senso ben determinato. Il com- plesso dei dischi che ci rappresenta, se si voule, un micelio, non ha la forma raggiata, e per consequenza non si puo denominar raggiata o come venne detto actinomyces, e nemmeno si debbono indicare i danni o le lesioni che produce con la parola actinomicosi. Il solo nome conveniente, a mio avviso, sarebbe quello di discomyces bovis, e con la parola sarcomicosi si potrebbero indicare le lesioni che produce vel corpo del bue.
Harz (28) then published a separate description of the fungus, rejecting Rivolta’s change.
Israel, (29) in 1878, used Actinomyces, but called attention to the similarity between the organism found in lesions in man and Cohn’s Streptothrix foersteri, a resemblance which, he said, Cohn himself had confirmed. Perroncito,(49) although himself employing Actinomyces, quoted a communication from Professor Garovaglio, director of the Cryptogamic Laboratories of the University of Padua, in which its previous use by Meyen (42) was noted.
Rivolta (54) later declared that he was willing to accept Actino- myces bovis, but added that one could, nevertheless, form a group of pathogenic discomycetes containing: (1) Actinomyces bovis Harz; (2) Discomyces pleuriticus canis familiaris Rivolta; and (3) Discomyces equi Rivolta and Micellone. The second is now Cladothrix canis Rabe. (1898), and the third is known as a Micrococcus (M. botryogenes Rabe., M. ascoformans Johne, etc.). The first is, therefore, the only one of these organisms remaining in Rivolta’s genus, as thus amplified by him, and is the type of the genus, both as originally published and as later amplified.
During this period systematists, who placed these organisms among the bacteria, denied the generic validity of Cohn’s Strepto- thriz. Winter,(61) Zopf, (63) Schroter, (58) and Baumgarten (5) considered it to be a synonym of Cladothriz. Schroter included, in the same family, the genus Actinomyces, this being apparently the first recognition of Harz’s organism in systematic classi- fication. Baumgarten concluded that the ray fungi belonged among the pleomorphic higher bacteria in the genus Cladothriz. MacFadyean(39) agreed that the organisms of actinomycosis probably belonged to the Schizomycetes; he held that the oc- currence of clublike elements in the granules was not of specific value because inconstantly formed.
58 The Philippine Journal of Science . 1919
Macé(87) also confused the genera, but in a new fashion. In 1888 he erroneously described for Cladothrix dichotoma a process of true branching and adopted(38} this generic name for the ray-fungus group. Sauvageau and Radais hold that he had never had the true Cladothrix under observation.
Affanassiew(1) at first called the organism of actinomycosis Bacterium actinocladothriz, but in the following year, 1889, Affanassiew and Schulz(2) gave the term Actinocladothrix gen- eric rank. The only evidence that we have encountered of the use of this name by anyone else is the mention, without refer- ence, of “Actinocladothrix nocardt,” in an article by Haass. (27)
De Toni and Trevisan, in Saccardo’s Sylloge Fungorum, (20) accepted these organisms as belonging to the Schizomyce- taceze. In the Cladothricee: “Sporae (arthrosporae) in fila- mentis normalibus obvenientes. Filamenta pseudo-ramosa” they included Sphaerotilus, Cladothriz, and a genus that they called Nocardia Trevisan: “‘Filamenta evaginata. Arthrosporae trans- formatione cocci singuli ortae.” In this genus they included Streptothrix Cohn, non Corda; Actinomyces Harz, non Meyen; and Discomyces Rivolta, five species being defined. The descrip- tion of these organisms as falsely branching was, of course, erroneous.
In 1890 Almquist(3) and Gasperini(23) described certain or- ganisms that they identified as species of Cohn’s Streptothrix. Kruse held that these species fell, with the organism of actinomy- cosis, into Zopf’s Cladothrix group. Rossi-Doria (55) soon de- scribed six new species of Streptothrix from the air and classed Actinomyces bovis Harz, which he is said to have renamed Strep- tothriz actinomyces, with them. Kruse(31) later also employed Streptothriz, differentiating it from Cladothriz.
From cases of actinomycosis in man Bostroem(11) repeatedly cultivated an organism that differed distinctly from that culti- vated by Israel. He concluded that it belonged to the Cladothrix group of the Schizomycetes and pointed out that it might be related to, or even identical with, Streptothrix foersteri Cohn.
Griiber, (26) in 1891, described as Micromyces hofmanni an organism that subsequent authors have included in the group under discussion.
Sauvageau and Radais’s(56) discussion of the confusion of Cohn’s Cladothrix and Streptothria has been referred to. They believed that the two were distinct; that Cladothriz, the most differentiated of the Bacteriacez, was falsely branched; and that Streptothriz, a true though very low hyphomycetous fungus,
xiv.1 Merrill and Wade: The Validity of Discomyces 59
to which the organism of actinomycosis belonged, showed true branching. They concluded that the latter really belonged to Oospora Wallroth (1831), but that, whether or not this was correct, it was necessary to discard Streptothrix Cohn because of Corda’s use of this name in 1839. De Toni and Trevisan’s description of Nocardia as falsely branching was incorrect, for although Nocard(47) had originally so described his “Bacille de farcin,”’ Metchinkoff had found that it was a true-branching orgahism. Kanthack (30) accepted Oospora and created the name Oospora indica for the parasite of Madura disease, having demonstrated the identity of actinomycosis and of certain myce- tomas. Lehmann and Neumann, (33) in 1896, introduced Myco- bacterium as a family name for a group that they considered intermediate between the Hyphomycetes and the Schizomycetes, but rather more closely related to the former, and at first adopted Oospora as the generic name for the organisms under discussion.
Gasperini,(24) in 1894, proposed the use of Actinomyces to include the whole group, discarding Streptothria; he listed eight- een species. Berestnew, (6) in 1897, accepted Actinomyces as valid and later(7) called attention to Gasperini’s publication, which apparently had been overlooked. Lachner-Sandoval, (32) in 1898, pointed out the invalidity of Oospora in this connection and also adopted Actinomyces. Levy (84) reviewed the question, concluding that all the described types were generically related and that Actinomyces was the proper designation for them. He did not note Rivolta’s original application of Discomyces. Leh- mann and Neumann, in the second (1899) edition of their work, substituted the family name Actinomycetes Lachner-Sandoval for their own Mycobacterium, the pathogenic forms placed in the genus Oospora now becoming Actinomyces. This broader application of the term to the entire group is not now widely accepted, though Mallory, (40) after Gasperini, employed it ten- tatively, and Babes(4) and other German authors still use it.
Migula, in his earlier (1895) classification, (43) included these organisms among the higher bacteria, in his family Chlamydo- bacteriacese. He separated Streptothriz Cohn from Cladothriz, giving it a much modified diagnosis. In Cladothrix Cohn he included C. bovis (Harz) Migula (Actinomyces bovis Harz) and C. foersteri (Cohn) Schroter (Streptothrix foerstert Cohn), thus perpetuating the error of the earlier systematists. As already noted, Macé had adopted this generic name, although from a different viewpoint. Later (45) Migula modified this genus rad-
60 The Philippine Journal of Science 1919
ically, removing those species that are now recognized to belong to the fungi.
Engler, in his Syllabus, (21) included Harz’s organism in the genus Sphaerotilus as “Sph. (Actinomyces) bovis,” thus adding a new name to the list of synonyms. He had not revised this grouping in the fifth (1907) edition.
Discomyces Rivolta was shown to be the correct designation for the genus by Blanchard(9) who, stimulated by Levy’s and Berestnew’s articles, reviewed the question of nomenclature. in adopting this term he had changed his earlier opinion, for he ~ had previously(8) employed Nocardia. His argument is based on accepted principles and should carry conviction. Previous to this the term had been practically ignored. It is true that Sheube(57) cites Nocard and then Blanchard as having advo- cated this term for Discomyces (Streptothrix) indica, but we have been unable to find any publication by Nocard in which it is used; on the other hand, in the third (1903) edition of Nocard and le Clainche’s Maladies Microbiennes des Ani- maux,(48) Actinomyces is used in connection with actinomy- cosis and Streptothrix with “farcin du boeuf.” Gedoelst(25) evidently accepted Blanchard’s decision, for he designated the genus Discomyces Rivolta 1878, and the organism of actinomy- cosis Discomyces bovis (Harz 1877) Rivolta 1878. Stitt(59) is apparently the only American authority who has adopted this name. Brumpt(12) in a discussion of the mycetomas, used Discomyces and still subscribes to it, for in discussing organisms presented in 1913 by Pinoy(51) to the Société de Pathologie exotique (Paris) as Nocardia he used the former rather than the latter term. Manson,(41) in subscribing to Brumpt’s classifica- tion of the mycetomas, also used the same nomenclature. Cas- tellani and Chalmers(13) employed Discomyces in 1910, although they later discarded it.
A new name was introduced by Ligniéres and Spitz, (35) who called a subtype of this group Actinobacillus. In a later arti- cle(36) they acknowledged the strict propriety of Blanchard’s argument in regard to the application of Discomyces to the general group, although they continued to use Streptothriz.
During this period certain German authors had adopted Acti- nomyces and Streptothriz as separate genera. This is exempli- fied by Petrusky’s(50) classification in which they are placed in a family which he terms Trichomycetes. Wright(62) believed that Actinomyces should be retained for the organism of actino- mycosis, which he emphatically maintained should be differ- entiated generically from other organisms of the group. He
x1v.1 Merrill and Wade: The Validity of Discomyces 61
rejected de Toni and Trevisan’s objection that Meyen had given the name to another organism as an unreasonably strict interpre- tation of the principles of botanical nomenclature. On the other hand, for the rest of the group he rejected Streptothriz and accepted Nocardia. This subdivision of the group has been adopted in several American bacteriological textbooks. How- ever, Chester (16) adopted the first classification of Lehmann and Neumann, except that Oospora was replaced by Streptothriz Cohn. Clements(17) included these organisms among the Schizo- ‘mycetes; he followed Migula’s earlier classification, except that Nocardia was substituted for Streptothrix Cohn, emend. Mig.
Foulerton(22) argued that, since the other names that had been proposed had dropped out of use, only Streptothrix and Actinomyces remained to be considered. He chose the former because, although Corda had used it in 1834, it had become uncer- tain to what particular organism the term had been applied; further, a committee of the Pathological Society of London in 1899 had recommended the term “streptotricosis” as the ap- propriate clinical designation for the infection. Musgrave and Clegg (46) acknowledged that N: ocardia was probably more strictly correct, but “chiefly because of usage, and therefore somewhat arbitrarily, tentatively accepted Streptothrix * * *”? They suggested the possible advantage of substituting an entirely new name, Carteria (Carterii, sic!), evidently hoping that by this means further controversy might be eliminated.
Pinoy has divided the group into Nocardia, which is to include most of the species, and Cohnistreptothriz, said to be designed to replace Cohn’s invalid Streptothrix. The article that con- tains his argument is probably one by Pinoy and Morax, (52) which is not available to us. According to Chalmers and Chris- topherson(15) the characteristics of this genus are preference for anaérobiosis, difficulty of cultivation, and nonproduction of arthrospores; in it they include Cohn’s Streptothrix foerstert and Israel’s Actinomyces from man (Streptothriz israeli Kruse, 1896).
Vuillemin, (60) as a result of the adoption by the 1910 meeting of the International Botanical Congress at Brussels of a program for the next congress that included the determination of the point of departure for the nomenclature of the Schizomycetes and the elaboration of lists of nomina conservanda for these organisms, has recently published a revised generic classifica- tion, which was intended to be submitted for consideration at the scheduled London (1915) meeting of the congress. In an appendix to this work he includes the family Microsiphones,
62 The Philippine Journal of Science 1919
composed of genera to certain of which organisms such as the “bacillus” of tuberculosis and the “bacillus” of diphtheria are as- signed. For the genus under discussion he adopts Nocardia Trevisan, which he recommends for inclusion in the list of nomina conservanda. He says, in effect, that systematic botany need not concern itself with the “medical genus” Dvsco- myces, in which Rivolta combined, without mycological signifi- cance, the parasites of actinomycosis, botryomycosis, and canine pleurisy, nor with the genus Cohnistreptothrix, founded by Pinoy upon bacteriological grounds, and that Nocardia remains the valid name for the genus. As the Congress did not meet in 1915, Vuillemin’s recommendations have not yet been acted upon.
Castellani and Chalmers have substituted, without discussion, Nocardia for Discomyces in the second edition of their work. (14) They remark that there are many points in favor of Pinoy’s subdivision of the genus, which probably would be soon generally accepted.
The most recent discussion of this question is in a study of actinomycotic mycetoma by Chalmers and Christopherson, (15) who enumerate sixty-three species of Nocardia and eleven of Cohnistreptothrix. They argue the validity of Nocardia on the grounds: (1) that it is the oldest name against which no objec- tions can be raised; (2) that it has been formally adopted by the Botanical Section of the First International Congress of Pathology ;' (8) that there are objections to the other names in use. They eliminate Discomyces, because:
Discomyces was used by Rivolta in 1878 merely as a trivial name, and though it has not been applied to any other genus, still the word Disco- mycetaceae was introduced in 1886 by Fries for a large fungal group and has come into general use, and therefore has the double claim of priority and general use, and as its type genus should bear the name Discomyces, confusion is bound to arise if the same term is retained for the generic name of Bollinger’s organism.
The value of these objections will not be discussed at this point.
SUMMARY
The source and present status of the various names that have been applied to the organisms of this group may be summarized as follows:
Cladothrix Cohn (1875). This name was used as generically
*This probably refers to the Congrés international de pathologie com- parée, organized by the Société de pathologie comparée, the first and as yet only meeting of which was held at the Faculty of Medicine, University of Paris, in 1912.
xiv,1 Merrill and Wade: The Validity of Discomyces 63
valid over Streptothrix Cohn (1875) by Winter (1884) and other systematists, the distinction not being understood. The organism of actinomycosis was informally assigned to this genus by Bostroem, Baumgarten, and others, formally by Migula (1895). Cladothrix Cohn is a different type of organism and the name is, therefore, inapplicable. |
Streptothrix Cohn (1875), non Corda (1839). This name was applied by Cohn to a true-branching organism but was placed in his classification as doubtfully synonymous with Cladothriz. The resemblance of the fungus of actinomycosis in man to it was noted by Israel (1878) ; the name was adopted in 1890 by Almquist and by Gasperini for nonpathogenic air organisms, and in 1891 it was adopted by Rossi-Doria for that of actinomycosis.
For a time this was probably the most widely used name for the group. At present it is frequently applied to the group minus the organism of actinomycosis. It is unquestionably in- valid in either connection because previously applied by Corda (1839) to an organism distinct from those under consideration.
Actinomyces Harz (1877) non Actinomyce Meyen (1827). This name was applied by Harz to the fungus of “lumpy jaw” of cattle, by Gasperini (1894) to the entire group, replacing Streptothriz, and accepted in this application by Berestnew (1897), Lachner-Sandoval (1898), and others.
It is now used by many writers, particularly the German and the American, as a valid name for the organism of actinomycosis only; it is seldom used in the more general sense. As is shown below, this name is invalid because published in connection with an entirely different organism by Meyen (1827).
Bacterium Ehrenberg 1830. Affanassiew (1888) is said for a time to have called the organism of actinomycosis Bacterium actinocladothriz. This designation is manifestly inapplicable.
Actinocladothrix Affanassiew and Schultz (1889). This was proposed as a generic name by Affanassiew and Schultz in 1889 for the organism of actinomycosis. It did not receive the con- sideration to which, being of even date with the widely adopted Nocardia, it was certainly entitled.
Micromyces Griiber (1891). This name was applied by Griiber to an Actinomyces-like organism that he called M. hofmannt. This organism cannot be distinguished from the general group under consideration.
Oospora Wallroth (1833). This was adopted by Sauvageau and Radais (1892), who concluded that the group belonged to Wallroth’s genus. Lehmann and Neumann (1896) adopted this view, but later abandoned it, Lachner and Sandoval (1898)
1623235
64 The Philippine Journal of Science 1919
having shown that Oospora Wallroth is an organism entirely different from those under discussion.
Sphaerotilus Kuetz. (1883). This name was adopted by Engler for the group including Cladothrix (Streptothrix) foerstert Cohn, with which he included Actinomyces bovis Harz. This disposition was undoubtedly due to the old misapprehension as to the distinction between Cladothrix and Streptothriz.
Actinobacillus Ligniéres and Spitz (1902). This name was ap- plied by Ligniéres and Spitz to a supposed subtype of this group. The distinction has not been recognized, and by most authors the name is considered a synonym.
Carteria Musgrave and Clegg (1908). The adoption of this new name (as “Carterii”) was tentatively suggested by Mus- grave and Clegg as possibly advantageous for the purpose of avoiding further controversy, although they did not definitely advocate this highly informal procedure.
Nocardia Trevisan (1889). This name was adopted by de Toni and Trevisan to cover the entire group. Blanchard used it for a time in its original application and Wright (1894) adopted it for nonpathogenic strains only. As many other authors use it in one sense or another, of late it has gained much prestige. Vuillemin, and Chalmers and Christopherson have recently adopted it for the entire genus.
The validity of this name we deny on the grounds indicated in the discussion that follows.
Discomyces Rivolta (1878). This name was definitely sub- stituted by Rivolta for Actinomyces, with the change of name of Bollinger’s fungus to Discomyces bovis. It was practically ignored until Blanchard (1900) argued its priority over Nocar- dia. Subsequently Gedoelst, Brumpt, Manson, Stitt, and for a time Castellani and Chalmers, adopted it.
As indicated in the discussion this name is clearly valid over Actinomyces and all subsequent names.
DISCUSSION
Before considering the validity of Discomyces for this group over Nocardia and Actinocladothriz, it is necessary to emphasize the invalidity of two older terms that have gained general recognition.
Streptothriz Cohn (1875) is invalidated by Streptothrix Corda (1839). It has been argued that there is doubt as to what organism is referred to by Corda’s name. This is apparently not the case for in recent years several new species have been described in Corda’s genus. Streptothrix Corda is unques-
xiv,1 Merrill and Wade: The Validity of Discomyces 65
tionably a valid, recognized genus, and Streptothriz Cohn must fall.
Actinomyces was used by Harz with but a very limited knowledge of the organism to which he applied it, evidently without suspecting its possible relationship to Cohn’s Strepto- thrix foersteri and probably without being aware of Meyen’s use of the name. Whether or not this newer application is valid, as most writers seem at least tacitly to agree, depends on the validity of its preémption by Meyen. That it is valid is evident from the following transcription from the original publication :
Actinomyce
Sporidochia, cellulis hyalinis simplicibus enormiter et multipliciter ramificantibus sporis impletis, substantiae uniformi gelatinosa hyalina induta.
Actinomyce Horkelii
R. forma irregulari sphaeroidea, gelatinosa duritie ad basin augente usque ad consistentiam cartilaginosam, colore hyalino-subcoeruleo. Hab. in pinguedine et pleuris animalium aquae submersis, autumno prope Coloniam Agrippinam.
Zum Schlusse wage ich noch, etwas itiber das beginnende Wachsthum dieses Pilzes zu sagen. Der Pilz ist nicht eine Krankheitsform eines Organismus, sondern er ist ein eigener Organismus, ein eigenes Leben unabhangig von seinem Mutterboden, aber dennoch von demselben be- schrankt.
It is to be noted that Meyen used the name Actinomyce. While by some the use of this form might conceivably be argued not to invalidate Actinomyces, the derivation of the two is identi- cal, and the argument cannot hold. Actinomyce horkelii Meyen is now an organism of uncertain status. Although it was described by Meyen as a fungus, the description apparently ap- plies to one of the colonial Cyanophycee. The genus is not recognized in either mycological or algological literature. How- ever, the description of both the genus and the species is indis- putably valid, and in the present connection the question of its identity is unimportant. In being validly published, it invali- dates the further use of the same name for another group of organisms in the plant kingdom.
From the foregoing it is evident that by the accepted principles of botanical nomenclature both of these names are preoccupied. To deny on this ground either of them and yet accept the other, as has been done, is inconsistent. Recommendation of “strepto- tricosis” by a committee of the Pathological Society of London cannot be accepted as competent to validate Streptothriz, nor ean the adoption by the Botanical Section of the First Inter- national Congress of Pathology validate Nocardia. It is true
66 The Philippine Journal of Science : 1919
that through formal adoption by the proper bodies nomina con- servanda are validated; however, neither of the societies men- tioned has authority to do this in botany.
There remains to be considered, then, the name next applied to this genus. This was published by Rivolta, in 1878, when he proposed, definitely and distinctly, to substitute Discomyces for Actinomyces.2. The reason for which he did this is an in- valid one; he believed that Actinomyces was not properly de- scriptive of the organism and, unhampered by rules of ‘nomenclature, adopted Discomyces as preferable in this respect. He was undoubtedly not aware of the fact that the former had been used before, but it is on this ground rather than that on which he advanced his new name that Discomyces is valid.
Vuillemin, and more recently Chalmers and Christopherson, in advocating Nocardia as the valid generic name, hold that Rivolta’s use of Discomyces was trivial and without botanical significance. We do not agree with this argument, which is clearly refuted by Rivolta’s original paper. Here he distinctly proposes Discomyces bovis as the name for the organism called Actinomyces bovis by Harz in a manner that must be acknowl- edged as valid from the viewpoint of botany, even though it is not in conventional form and was advocated on irrelevant, in- adequate grounds. Therefore, it is in no sense a “medical genus,” as Vuillemin asserts. The fact that subsequently | Rivolta erroneously referred other organisms to this genus has no bearing on the case. His original application of it was to the organism of Bollinger and Harz alone, which is, therefore, the type of the genus. Nor does the fact that, to propitiate Harz, Rivolta later agreed to accept Actinomyces affect the question. As Blanchard pointed out, a name once introduced
?'The definite manner in which this substitution was made has been generally ignored, possibly because of the inaccessibility of the original paper, it having been published in an Italian veterinary journal. The rarity of this publication is exemplified by the difficulty that we have had in consulting it. The 1878 volume of Clinica Veterinaria was found to be missing from the set of this periodical in the Surgeon-General’s library in Washington, whereupon Mr. P. L. Ricker, of the United States Depart- ment of Agriculture, to whom we had applied, requested it from Mr. B. B. Woodward, librarian of the British Museum. He, not finding the publi- cation in that library, forwarded the request to Mr. F. Bullock, of the Royal College of Veterinary Surgeons, through whose kindness a separate of Rivolta’s article was forwarded to Washington, where photostat repro- ductions were made, one of which Mr. Ricker forwarded to us. To these gentleman we express our appreciation.
xiv.1 Merrill and Wade: The Validity of Discomyces 67
is no longer the property of its originator to withdraw or modify at will.
Finally, to argue, as do Chalmers and Christopherson, that Discomycetacez, a group name, invalidates Discomyces as a generic name in the connection in which Rivolta used it, on the ground that the type genus of Fries’s Discomycetacee, published in 1836, should bear the designation Discomyces, in- dicates an erroneous conception of the principles of nomencla- ture and priority in technical names; a family name such as Discomycetacee cannot invalidate the generic name Discomyces any more than a generic name can invalidate a similar specific name. This generic name was new with Rivolta, and there is no valid objection to its adoption in taxonomy.
Nocardia is no longer to be considered. Both it and Actino- cladothriz of Affanassiew and Schultz, the publication of which seems to have been completely ignored,. were proposed eleven years later and fall as synonyms of Discomyces Rivolta (1878), which genus is typified by Discomyces bovis (Harz) Rivolta.
The question of division of the group is a different matter. It is our conception that the group, exhibiting as it does wide differences among the species, should be subdivided. However, neither the characters upon which separation was advocated by earlier writers (granule formation in tissues, club-ended fila- ments in the granules), nor those advanced by Pinoy (difficulty of cultivation, anaérobiosis, absence of arthrospores), ‘seem to be convincing for generic distinction. Granules may be formed in animal lesions by a variety of these organisms, and club formation is a variable feature even in typical actinomycosis. Anaérobiosis and difficulty of cultivation are not generically dis- tinctive botanically, nor so considered for other groups of mi- crodrganisms from the bacteriological viewpoint. Furthermore, these features characterize both the strains described by Israel and those studied by Wright. Should it appear desirable to di- vide the genus, this will probably be done on the basis of mor- phologic rather than metabolic differences.
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(33) LEHMANN, K. B., and NEUMANN, R. O. Atlas und Grundriss der Bakteriologie und Lehrbuch der speciellen bacteriologischen Diag- nostik. Miinchen, 1. Auf. (1896), Teil IT.
(34) Levy, E. Centralbl. f. Bakt., etc., 1. Abt. (1899), 26, 1.
(35) Licnizres, J., and Spirz, G. Bull. Soc. centr. Méd. veter. (1902), 487. Ref.: Centralbl. f. Bakt., etc. Ref. (1902), 32, 781.
(36) IpEM. Centralbl. f. Bakt., etc. Orig. (1904), 35, 294, and 452.
(37) Mac&, E. Compt. rend. Acad. Sci. (1888), 106, 1622.
(38) IpEM. Traité pratique de Bactériologie. Paris (1889). Cited by Sauvageau and Radais. ;
(39) MacFapyEan, J. Brit. Med. Journ. (1889), 1, 1339.
(40) Matxory, F. B. Bost. Med. & Surg. Journ. (1895), 132, 296.
(41) Manson, P. Tropical Diseases. 4th ed. New York (1907), 759.
(42) Meyen, J. Linnaea (1827), 2, 441.
(43) Micuta, W. In Engler and Prantl, Die natiirlichen Pflanzenfamilien. Leipzig, Teil I, Abt. ia, (1895), 1.
(44) Ipem. System der Bakterien. Jena (1896), 1, 21 et seq.
(45) Ipem. Ibid. (1900), 2, 1033.
(46) Muscrave, W. E., and CLecc, M. T. Philip. Journ. Sci., Sec. B (1908), 3, 470.
(47) Nocarp, E. Ann. Inst. Past. (1888), 2, 293.
(48) Nocarp, E., and LE CLAINCHE, E. Les Maladies microbiennes des Animaux. 3d ed. Paris (1903), 2.
(49) Prerroncito, E. Deutsche Zeitschr. f. Thiermed. u. vergl. Path. (1879), 5, 33.
(50) Perrusky. In Kolle and Wassermann’s Handbuch der pathogenen Mikroorganismen. Jena (1903), 2, 832; and ibid., 2d ed. (1913), 5, 267.
(51) Pinoy, E. Bull. Inst. Past. (1913), 11, 927 and 977.
(52) Pinoy and Morax. Bull. Soc. Ophthalmol. Paris (1911), No. 3. Cited by Pinoy (1913).
(58) Rivotta, 8. Clinica Veterinaria (1878), 204 (Nos. 7, 8, and 9). Also abstracted and discussed by Bollinger in Deutsche Zeitschr. f. Thiermed. u. vergl. Path. (1879), 5, 110. Also quoted by Blan- chard (1900).
(54) IpEM. Giornale Anat. Fisiol. e Patol. (1884), 16. Cited by Blan- chard (1900).
(55) Rosst-Dorta, T. Ann. R. Univ. Roma (1891), 1, 399. Ref.: Baum- garten’s Jahresb. (1891), 7, 348.
(56) SAUVAGEAU, C., and Rapais, M. Ann. Inst. Past. (1892), 6, 242.
(57) ScHEUBE, B. Die Krankheiten der warmen Lander. Jena (1900), 625.
(58) ScHROTER. Die Pilze, Bd. III. In Kryptogamenfiora von Schlesien. Bakterien (1886). Quoted by Migula (1896), 1, 30.
(59) Srirt, E. R. Practical Bacteriology, Blood Work and Animal Para- sitology. 4th ed. Philadelphia (1918), 158.
(60) VumttemiIn, P. Ann. Mycolog. (1918), 11, 512.
(61) Winter, G. In Rabenhort’s Kryptogamen-Flora von Deutschland, etc., Die Pilze. Leipzig (1884), 1, 1 Abt., 38.
(62) WricHT, J. H. Journ. Med. Res. (1904), 13, 349.
(63) Zopr. Die Bakterien. 1. Aufl. (1884); 2. Aufl. (1885). Quoted by Migula (1896), 1, 26.
IONTHA IDA, A NEW PHILIPPINE NOCTUID
By CHARLES S. BANKS*
(From the Department of Entomology, College of Agriculture, University of the Philippines, Los Bafios)
ONE PLATE LEPIDOPTERA: HETEROCERA
NOCTUIDA: QUADRIFIN 4?
Genus IONTHA Doubleday ? Iontha ida sp. nov.
Male.—Head dark brown; eyes nearly black; apical segment of palpus ringed with ochraceous scales at middle, antenne reddish; body and wings dorsad and ventrad a faded, dark, yellowish brown, the wings above darker apicad and highly bronze-irides- cent; a darker reniform, median, subcostal spot on fore wing circumscribed by a very few heliotrope scales and punctured centrad by one or two ochraceous scales; a faint brown zigzag line connects it with caudal margin, at which point is a very tiny patch of heliotrope scales; a dark brown dot, similarly circumscribed, five-eighths of the distance from base of wing to reniform spot; a submarginal row of six dark brown dots from apex to anal angle on outer margin. Each of these dots lies within an area of diffused heliotrope scales forming more or less of a circle around the individual spot but all running together to form an indistinct marginal band; ectad of this a thin, dark brown wavy line; marginal cilia alternately white and brown, the white being subjacent to the respective submar- ginal dots. Hind wings with a similar pale heliotrope band containing about five distinct, dark brown dots, almost obsolete at outer angle but growing more marked toward anal angle, which is much produced and lobed laterad and somewhat re- curved (See Plate I, fig. 1). Fore wings ventrad uniformly brown, irrorated with heliotrope on apical area and with a
1 Professor of entomology and chief of the department. The Entomologist (1842), 298, 1 figure. 71
72 The Philippine Journal of Science 1919
subcostal, ill-defined, darker brown, transverse spot beyond me- dian area; marginal cilia as on dorsal’ surface. Hind wings ventrad slightly darker iridescent brown, strongly irrorated with heliotrope scales over costal and outer areas and with a row of linear, heliotrope dots extending from costa obliquely across the cephalic two-thirds of wing to a line from base to anal lobe. Of these dots the costal is most prominent and almost white. These dots have faint counterparts on the dorsal surface but the latter extend farther toward inner margin, which is heavily fringed with pale brown cilia; the basal, median, and inner areas of the hind wing and the basal area of the fore wing on their dorsal surfaces are heavily clothed with long hair of a golden brown hue. Tegule concolorous with wings.
Ventral surface of thorax and abdomen whitish ochraceous, growing darker toward apex of abdomen, so that sixth abdominal sternite has a diffused, longitudinal, brown, median stripe, and seventh is nearly all brown, with sublateral suffusions of helio- trope. Anal tuft nearly as long as abdomen, very dark iri- descent brown, the iridescence more marked ventrad. Fore and mid legs with femora and tibize brown ectad, creamy white entad; tarsi brown with creamy white at articulations. Hind legs uniformly brown, very hirsute, the tibie and tarsi having very dark brown hairs, lying in the same plane, lengthening toward apex of tibia and growing shorter toward apex of tarsus.
Total length (including palpi and anal tuft), 48 millimeters; width of head, 5.25; length from front of head to apex of ab- domen, 30; length of anal tuft, 18. Expanse of wings, 60 milli- meters; length of fore wing, 28; length of hind wing, 23; length of antenna, 20; length of hind leg, 23; hind tibiotarsal length, 17; tibial fringe, 4.
Luzon, Laguna, Los Bafios, P. I.; July 8, 1915 (Charles S. Banks). A single specimen flew into my house at night and, rapidly half crawling, half flying, around on the table, was cap- tured without injury.
Type, No. 18468, male, in the entomological collection, College of Agriculture, Los Bajios, P. I.
This species is closely related to Jontha umbrina Doubleday,* from which it differs most strikingly in having the anal angle of the hind wing lobed and much reflexed ectad; in having the heliotrope submarginal band extended to anal angle on hind wings and equally as well marked as on the fore wings, and in the alternately pale and dark brown fringe of the fore wings.
~
*The Entomologist (1842), 298, 1 figure.
XIV, 1 Banks: A New Philippine Noctuid 73
Its very striking appearance differentiates it at once from all other noctuids that I have seen, and its graceful actions are not easily forgotten when once they have been witnessed.
I dedicate this beautiful insect, the first and only one of its genus ever taken in the Philippines, to my mother, Ida Randolph Banks.
Its closest ally, lontha wmbrina Doubleday, is recorded from Sylhet, in northern India, by all authors and from Singapore by Swinhoe. Hampson‘ gives Borneo in addition but, as he cites no collector, this may be an error.
“Fauna of British India, Moths (1894), 2, 541, fig. 301.
ILLUSTRATION PLATE I
Iontha ida sp. nov., natural size. a, dorsal aspect; b, ventral aspect; c, lateral aspect. 15
BANKS: IONTHA IDA.] [PHILte. Journ. Sct., XIV, No. 1.
PLATE |. IONTHA IDA SP. NOV., NATURAL SIZE.
THE SOCIAL BEES OF THE PHILIPPINE ISLANDS
By T. D. A, CockERELL (University of Colorado) The social bees of the Philippines are included in three families, easily distinguished as follows:
Anterior wings with reduced venation; small, stingless bees.... Meliponide. Anterior wings with three submarginal cells; larger bees, with sting in
females and workers. ge is
1. Eyes hairy; marginal cell long LDOROY. HOON coe cet ectigeeeeg ss Apide.
Eyes naked; large hairy bees (HOMbiS Bete) Bombide. MELIPONIDZ
A large family of social bees, abundant in the tropics of both hemispheres, but absent from the temperate parts of the north- ern hemisphere, though extending south of the tropics in Aus- tralia. The only Philippine genus is the following:
Genus TRIGONA Jurine
The record of T. leviceps Smith is probably erroneous. The following species are known to occur:
Base of abdomen bright ferruginous, the following segments intense black, abruptly contrasting palavanica Cockerell. Abdomen ‘not thas bieolredicca ge oe co ee i si
1. Larger, the worker 6.5 to 7 millimeters long; abdomen ferruginous. luteiventris Friese.
Smaller, worker about 3.75 millimeters long; abdomen dark. biroi Friese.
Trigona palavanica Cockerell. Trigona palavanica COCKERELL, Ann. & Mag. Nat. Hist. (1915), VIII, 16, 2. PALAWAN, Puerto Princesa (from Baker).
Trigona luteiventris Friese. Trigona luteiventris FRIESE, Résult. L’Expéd. Sci. Néerlandaise a la Nouvelle-Guinée. Leiden (1900), 5, Zoologie, 358.
PALAWAN; also Perak.
Trigona biroi Friese. Trigona biroi FRIESE, Termés. Fiizetek (1898), 21, 429. Philippines and New Guinea, according to Friese. Philippine
Islands (C. R, Jones). 17
78 The Philippine Journal of Science 1919
LuZON, Los Bafios (Baker): Bataan, Lamao (P. J. Wester), at flowers of Nipa fruticans, February 26, 1916.
I take the opportunity to make known some species obtained by Professor Baker in Penang and Singapore:
Trigona ambusta sp. nov.
Worker.—Length, 8.5 millimeters; anterior wing, 8 milli- meters. Head large, shining black, the clypeus ferruginous, broadly suffused with dusky above and at sides; antennez dark, except basal third of scape, which is bright ferruginous; man- dibles simple; front with fine brown pruinose tomentum; a band of stiff black hair behind ocelli; mesothorax and scutellum fer- ruginous, the latter with two dark marks and the mesothorax with dusky lines anteriorly; surface of mesothorax with very short thin rich fulvous tomentum, and anteriorly with black hairs; scutellum with short stiff black hairs; metathorax hairy at sides, but the broad central portion polished, shining black; pleura black in middle, reddish around sides, and red below; tegulz castaneous; wings fuliginous, with the apical field broadly reddish hyaline; stigma and nervure dusky reddish; legs black, the coxe and trochanters red; abdomen black (extreme base of first segment red), narrow, compressed, shining, with dark hair at apex.
SINGAPORE (Baker 9067). Allied to T. lacteifasciata Cameron, from Borneo, but with black femora, basal part of wings dark, and other differences. It is also related to T. thoracica Smith, differing in the color of the wings, which Smith describes as flavo-hyaline in his species.
Trigona atripes Smith, a variety differing a little in the color of the legs, comes from Penang Island (Baker 9068). The following species with black head and thorax were obtained by Baker on Penang or at Singapore:
Mesothorax dull, bordered with fulvous hair (Penang). fulvomarginata sp. nov. (9073).
Moacthcias not thus bordered..... DH 1. Small species, with red scape 3; Larger species; scape black, at most red at extreme base....................--- 3. 2. Tegule ferruginous (Singapore) valdezi sp. nov. (9074). Teguiz black (Penang).. -- penangensis sp. nov. (9075).
3. Larger; transverse-cubital nervures barely indicated (Singapore). busara sp. nov. (9072). Smaller; transverse-cubital nervures distinct.... 4. 4. Scutellum bare (Penene) na bakeri sp. nov. (9069). Scutellum conspicuously hairy (Singspors). itama sp. nov. (9071=type; 9070).
XIV, 1 Cockerell: Social Bees of the Philippines 79
Trigona fulvomarginata is very close to T. ventralis Smith and has the abdomen whitish at base and beneath as in ventralis. It differs by the dusky wings and the bright fulvous hair bor- dering mesothorax and scutellum. The scape is pale at the extreme base, and the face has short grayish white hair.
Trigona valdezi and penangensis belong to the iridipennis and biroi series. They differ at once from iridipennis by the dusky wings. The wings of penangensis are less produced apically than those of iridipennis, and the abdomen is pure black. Trigona biroi is larger than penangensis and has darker wings. Trigona valdezi is 5 millimeters long, but penangensis is not over 4. The abdomen of valdezi is brown, palest basally; that of penangensis is pure black. Trigona valdezi is also close to T. leviceps Smith, but differs by the black femora, tibie, and middle and hind basitarsi.
Trigona busara is about 7 millimeters long, robust, with dusky wings; stigma and nervures dilute sepia; face and front cov- ered with cinereous pile; scutellum with much black hair; pleura with mouse-colored tomentum above, grading into cine- reous below; legs black.
Trigona bakeri and T. itama are much alike, about 6 milli- meters long, with dilute fuliginous wings, noticeably darker than those of, JT. busara. The front mesothorax and abdomen are shining, but in bakeri the mesothorax is extremely smooth and polished, in itama distinctly dullish. The legs are black in both. Trigona busara, bakeri, and itama all have the abdomen shining black.
The following, described by Smith from Singapore, are not represented in the collection: Trigona fimbriata, T. leviceps, and T. thoracica. Smith described four others from Mount Ophir; one of them (7. atripes) was found on Penang. It is a fulvous insect, quite unlike the others here described.
APIDA
I recognize only a single genus, though the segregates pro- posed by Ashmead may be considered subgenera.
Genus APIS Linnzus
Large species, workers about 16 to 18 millimeters, with eyes somewhat converging above; second recurrent nervure joining third submarginal cell very near its apex * a caioussescigiabac Subgenus Megapis Ashmead.
Medium-sized species, typified by the common honey bee; second recurrent nervure not going so near end of third submarginal cell.
Subgenus Apis Linnzus.
Small species, workers about 8 millimeters........ Subgenus Micrapis Ashmead.
1623236
80 The Philippine Journal of Science 1919
Subgenus Megapis Ashmead
Basal half of abdomen clear LOPTYUMINOUES 2 eens alas dorsata Fabricius. Abdomen black, with a band of,white tomentum at base of second segment. binghami Cockerell.
Subgenus Apis Linneeus
Length of worker, 10 to 13 millimeters; labrum black... mellifera Linnzus. Length of worker, 9 to 11 milimeters; labrum and more or less of clypeus Pees POGUE ee indica Fabricius.
Subgenus Micrapis Ashmead
One species; labrum and clypeus dark florea Fabricius.
Apis dorsata Fabricius. Apis dorsata Fasricius, Ent. Syst. (1798), 2, 328. Listed by Ashmead.
Apis binghami Cockerell.
Apis binghami COCKERELL, Canad. Entom. (1906), 166 (zonata Smith, preoccupied). .
LUZON, Mount Banahao (Baker); Bacoor (P. L. Stangl) ; reported by Ashmead. ses Apis mellifera Linnzus.
Apis mellifera LINNZ&vs, Syst. Nat. (1758), 10, 576 (later called mellifica by Linnzus). .
Presumably occurs only as a domesticated insect. Apis indica Fabricius. Apis indica Fasrictus, Ent. Syst. Suppl. (1798), 274. LUZON, Los Bajios. MINDANAO, Dapitan (from Baker). The Philippine specimens seen by me have the abdomen banded con- spicuously with black, and belong to the race nigrocincta Smith.
The form unicolor Latreille, with black abdomen, has been re-
ported by Ashmead from Cagayan and Alcala. Ashmead reports nigrocincta from Manila (Stanton).
Apis florea Fabricius. Apis florea FABRICIUS, Mant. Ins. (1787), 1, 305.
Said to occur in the Philippines. I have none from the Islands.
BOMBIDA Genus BOMBUS Latreille
Body covered with pale hair, some black intermixed on abdomen; wings BIMING coc cccicccie cc, bes -- Mearnsi Ashmead.
XIV, 1 Cockerell: Social Bees of the Philippines R1
Hair of head nearly all black, of thorax above black, but on pleura fulvous; abdomen with first two segments yellow-haired, the others with black; Wings Tualiginoig scenes sees irisanensis Cockerell.
Bombus mearnsi Ashmead. Bombus mearnsi ASHMEAD, Proc. U. S. Nat. Mus. (1905), 28, 959; COCKERELL, Ann. & Mag. Nat. Hist. (1905), VII, 16, 393. MINDANAO, Mount Apo, 6,000 feet (HF. A. Mearns). Type in United States National Museum.
Bombus irisanensis Cockerell. Bombus irisanensis COCKERELL, Ann. & Mag. Nat. Hist. (1910), VIII, 5, 416,
Luzon, Benguet, Irisan (collector unknown). Type in Brit- ish Museum. Structurally resembles B. swmatrensis Ckll., from Sumatra, but the colors are quite different. Bombus is known - from Java (B. rufipes Lep.), Sumatra (B. senex Snell., B. rufipes melanopoda Ckll., and B. sumatrensis Ckll.), and the Philippines ; _ but not yet from Borneo.
THE PHILIPPINE BEES OF THE FAMILY NOMADIDA#
By T. D. A. COCKERELL (University of Colorado)
The Nomadide are represented in the Philippine Islands by species of Nomada Scopoli, a genus very widely spread over both hemispheres. The Philippine species are all small and look like small wasps. They are parasitic, presumably in the nests of the various species of Halictus. Those so far recog- nized may be separated thus:
Genus NOMADA Scopoli
Anterior wings with two submarginal cells..............---.-..-.------:e---eeeeee 1.
Anterior wings with three submarginal cells..... Sa 4.
1: Meéesothorax of female black 2.2.0.2. cc pervasor sp. nov.
Mesothorax of female red, at least at sides.............. z.
"S- Pront black, except along orbits u.......2.. cn. attrita sp. nov. I GG ie Seek i 3.
3. With a yellow spot at each side of second abdominal segment. makilingensis Cockerell.
Without such yellow spots Ns jsabcdeWinpaddamtidideclebousscubtes palavanica sp. nov. a ee in ek 5. Females 6.
5. Third antennal joint short, little longer than broad.* banahaonis Cockerell. Third antennal joint long, much longer than broad. . mindanaonis Cockerell. 6. With a conspicuous yellow spot at each side of second abdominal segment. exheredans sp. nov.
Waicnont 80th Bow i eee i re 7. Mesothorax black, at most with a little red at sides 8. Mesothorax red, with at most a blackish discal shade...............-.....---------- 9.
8. First abdominal segment with a broad red band; hind tibie red. concessa sp. nov.
First abdominal segment black, with small red spots; hind tibize black,
with the ends red bakeri Cockerell.
9. Hind margins of abdominal segments suffused with dusky; flagellum dull red beneath en PERE LE LOE OE ACCOR RAG FE lusca Smith. Abdomen usually clear red; flagellum black........ mindanaonis Cockerell.
* The second joint is very small and partly hidden in the apex of the first, so it is possible to mistake the third for the second.
83
84 The Philippine Journal of Science 1919
Nomada pervasor sp. nov.
Male (type).—Length, about 6 millimeters; black, with the following chrome-yellow markings: Basal part of mandibles (which have no inner tooth), labrum, lower margin of clypeus, small triangular areas at lower corners of face, claviform streak above eyes, scape in front except at base (but suffused with reddish), tubercles, tegule (except a dark spot), scutellum (which is bilobed), apical part of femora (especially in front), tibiz (except a dusky mark, and on hind tibize the middle half dark, except a stripe behind), anterior tarsi and middle basitarsi, large spots on each side of second and third abdominal seg- ments, smaller (paler) marks on fourth, a briefly interrupted band on fifth, and a broad complete band on sixth. Middle of face and a transverse mark on pleura reddish; apical plate of abdomen pale ferruginous, very deeply notched; flagellum long, black; third. antennal joint a little longer than fourth; meso- thorax very densely and coarsely punctured; wings with only two submarginal cells, the second transverse-cubital nervure lacking; apical part of wings strongly infuscated; basal nervure going far basad of transverse median; abdomen polished and- shining, first segment entirely black.
Female.—Similar to the male in most respects; a large, quad- rate, subapical yellow patch (more or less emarginate anteriorly) on abdomen.
LUZON, Benguet, Baguio (Baker), 1 male, 3 females.
Nomada attrita sp. nov.
Female.—Length, a little over 4 millimeters; differing from N. makilingensis thus: Smaller; front black, with a red band along each orbit; mesothorax with middle third or rather more black, lateral parts dusky red; abdomen beyond first segment suffusedly blackened.
MINDANAO, Butuan (Baker collection).
Nomada makilingensis Cockerell.
Nomada makilingensis CocKERELL, Ann. & Mag. Nat. Hist. (1915), VIII, 15, 263.
Luzon, Laguna, Mount Maquiling (Baker).
Nomada palavanica sp. nov.
Nomada mindanaonis, variety, CockErett, Ann. & Mag. Nat. Hist. (1915), VIII, 15, 4.
Female.—Length, about 5.5 millimeters; differing from N. makilingensis by the absence of yellow spots on second abdo- minal segment, the black flagellum, and the dusky hind legs.
XIV, 1 Cockerell: Philippine Nomadidz 85
PALAWAN, Puerto Princesa (Baker collection). I was evi- dently in error in regarding this as a variety of N. mindanaonis ; the first recurrent nervure joins the second submarginal cell much nearer the base than in that species.
Nomada banahaonis Cockerell.
Nomada banahaonis CocKERELL, Ann, & Mag. Nat. Hist. (1915), VIII, 15, 264,
Luzon, Mount Banahao (Baker). The male varies in size; length, 4.5 to 6 millimeters.
Nomada mindanaonis Cockerell. Nomada mindanaonis COCKERELL, Ann. & Mag. Nat. Hist. (1915), VIII, 15, 265.
MINDANAO, Dapitan (type locality) ; Davao. PALAWAN, Puer- to Princesa. All from Baker. The tegule of the male vary to red. The females vary, Davao specimens showing more or less dusky shades on the abdomen. It becomes difficult to separ- ate females of this species from N. lusca, but I have no male of lusca from Luzon. It is quite possible that N. mindanaonis is only a local race of lusca, differing in average rather than absolute characters. The type is a male.
Nomada exheredans sp. nov.
Female.—Length, about 5.5 millimeters; red with blackish markings, the second abdominal segment with a large round yellow spot on each side; mandibles simple; front, occiput, and cheeks black, but a red band along orbits; scape long, red, with a dusky spot at apex behind; flagellum very long, reddish black, the basal half red beneath; third antennal joint about as long as fourth; mesothorax dusky red, with a broad median black stripe and obscure sublateral ones; white hair patches on meso- thorax dense and bright; tegule clear red; wings dusky at apex; basal nervure going a short distance basad of transverse median; second submarginal cell large; legs’ clear ferruginous, only the hind tarsi dusky; abdomen with broad dusky bands; venter clear red.
LEYTE, Tacloban (Baker collection).
Nomada concessa sp. nov.
Female.—Length, about 6 millimeters; black,, marked with yellow and red; closely related to N. bakeri, but differing thus: Mesothorax very distinctly shining between the punctures, its lateral margins reddish; first abdominal segment broader, and with a broad band; hind tibiz red.
MINDANAO, Dapitan (Baker collection).
86 The Philippine Journal of Science
Nomada bakeri Cockerell. Nomada bakeri COCKERELL, Ann. & Mag. Nat. Hist. (1915), VIII, 15, 2638.
LuZON, Mount Maquiling (Baker).
Nomada lusca Smith. Nomada lusca SmitH, Cat. Hymenop. Insects British Museum, pt. 2 (1854), 248; BincHAM, Fauna British India, Hymenoptera (1897), 1, 465; COCKERELL, Trans. Amer. Ent. Soc. (1905), 31, 318; COCKERELL, Ann. & Mag. Nat. Hist. (1915), VIII, 15, 263. Luzon, Los Bafios; Benguet, Baguio (Baker). This species was briefly described by F. Smith from the Philippine Islands, the particular island not stated. I have examined Smith’s type in the British Museum. Bingham recorded the species from “Sikhim; Tenasserim; Ceylon; Philippines;” remarking how- ever that the variety he described appeared to be intermediate between the Philippine N. lusca and the Indian N. adusta. I have little doubt that true N. lusca is confined to the Philippines, the Indian specimens belonging to one or more distinct species. Bingham was inclined to lump species in Nomada; thus he placed N. subpetiolata Smith as a synonym of N. adusta Smith, but Meade-Waldo later reéstablished it as a valid species.
THE OSTEOLOGY OF THE GIANT GALLINULE OF THE PHILIPPINES, PORPHYRIO PULVERULENTUS TEMMINCK
WITH NOTES ON THE OSTEOLOGY OF TACHYBAPTUS PHILIPPENSIS (BONNATERRE) AND HYDROPHASIANUS CHIRURGUS (SCOPOLI)
By R. W. SHUFELDT (Major, Medical Corps, U. S. Army, Washington, D. C.) FIVE PLATES
Before describing the skeleton of this big paludicoline bird, it will be as well to present a brief history of what we know of its habits, distribution, taxonomy, and other matters of interest. For this history I am indebted to Mr. Richard C. McGregor, ornithologist of the Bureau of Science at Manila, who has kindly furnished me with the following notes:
Porphyrio pulverulentus Temminck. Porphyrio pulverulentus TEMMINCK, Pl. Col. (1826), 5, Pl. 405; SHARPE, Cat. Bds. Brit. Mus. (1894), 23, 207; Hand-list (1899), 1, 109; McGrecor, Man. Phil. Bds. (1909), 81.
Distribution.—Philippine Islands. ®
At the time that Sharpe wrote volume 23 of the Catalogue of Birds, the British Museum possessed only two specimens of the Philippine blue gallinule; these are listed as follows:
a. Ad. sk, Manila, Luzon. Hugh Cuming, Esq. [C.]. b. Juv. sk. Manila. Gould Coll.
It is very unlikely that either of these was collected in the vicinity of Manila. That they came from Laguna de Bay is probable, for the species can be found at many points along the shores of that lake, but it is nowhere as abundant as the moorhen (Gallinula chloropus).
Since the Catalogue of Birds was written, this gallinule has been collected in Bohol, Mindanao, and Mindoro, as well as in Luzon. It is probable that it occurs on all of the larger islands where there are suit- able lakes with shallow reed-filled water near the shores.
The food of Porphyrio, as indicated by the stomach contents of speci- mens collected at Paete, Laguna, Luzon, consists of fresh-water snails, small insects, seeds, and vegetable matter that could not be determined. When startled or surprised this gallinule stands erect, as if at attention. From this and its conspicuous red bill the Spaniards called it “artillero.”
The most conspicuous external features of this bird are the heavy bill and long, heavy feet. It has a striking resemblance to the pictures of Notornis, next to which the genus is placed in Sharpe’s Hand-list. See the text figure of Notornis in Knowlton, Birds of the World, page 325, and in Newton, Dictionary of Birds, page 592. You will notice that the
87
88 The Philippine Journal of Science 1919
frontal shield in the specimens of P. pulverulentus extends much farther backward than is represented by Newton for either Notornis or for Por- phyrio. If you happen to have a copy of Egyptian Birds, by Charles Whymper, London, Adam and Charles Black, 1909, you will find, facing page 168, some nice studies of Porphyrio madagascariensis that might pass for the Philippine Porphyrio if done in black and white.
In times past, in various journals here and in Europe, I have published complete accounts of the skeletons of all the American Gruide, or cranes; a full description of the skeleton of Aramus vociferans; and the same of the majority of our Rallide, or rails, gallinules, and coots. These papers and monographs are now so well known to ornithotomists and to many ornithologists, that it will not be necessary to cite them by title in the present connection. This also applies to such descriptions as I have published on the osteology of paludicoline birds of the Old World and elsewhere.
At the present writing I have been unable to obtain the skeleton of an American gallinule; so I shall compare the bones of the Philippine giant gallinule with the corresponding ones in the skeleton of a coot (Fulica americana). Such material has kindly been loaned me by the Division of Birds of the United States National Museum. (No. 19710, adult male ?)
There are but few marked differences to be discovered when we come to compare the skeletons of the soras, the cranes, the short-billed rails, the gallinules, and the coots, or other closely allied forms in the same group. Still there are some interesting points to be noticed along such lines, and they are of generic as well as specific significance. Most of them, it would seem, pertain to the skull rather than to any other part of the skeleton.
OSTEOLOGY OF PORPHYRIO PULVERULENTUS
The skull—As compared with Fulica, there is a general lack
of pneumaticity in the entire skeleton of this big gallinule, which is corroborative evidence that the demand for its being a good flier is considerably less; moreover, it points to the fact that its relation to Notornis is much nearer than any of its con- geners of the allied groups of the Rallide. This reduction of the amount of air gaining access to the inner recesses of the bones is well exemplified in the skull, as compared with that part of the skeleton in the coot; consequently we find it to be, in the gallinule, thicker, denser, darker, and proportionately heavier in comparison—a condition which is largely extended to other parts of the skeleton, as will be seen further on in this description.
XIV, 1 Shufeldt: Osteology of Porphyrio 89
Viewed upon its superior aspect, the skull of Porphyrio will be seen to be very broad in its interorbital area, generally convex, with almost complete reduction of the superorbital glandular fosse, and, posteriorly, faintly differentiated from the parietal area of the cranium. The craniofacial line is not as strongly marked ag it is in Fulica, though on both the naso-premaxillary sutures are distinctly in evidence on this superior view of the skull.
When we come to regard the cranium of this gallinule laterally, we find a number of very striking differences, as compared with what obtains in our coot. In the former, the superior mandible is proportionately far more massive, broader, and deeper from above downward. Furthermore, its decurvature is more pro- nounced, and it is carried more abruptly to a sharper apex. The osseous roof of the mouth is not as open as it is in the coot, while the external narial apertures in this Porphyrio are rela- tively, as well as actually, very much smaller and of an elliptical outline (Plate II, fig. 10).
A lacrymal bone in our subject differs very considerably from that element of the cranium in Fulica; for in the first-mentioned bird its superior portion is curved and elongate, making close articulation with the external margins of the frontal and nasal. It is pneumatic, while the foramen is usually in the lower portion. This latter is rather broad, thin, curved, and pointed below; a small, free ossicle brings it in articulation with the infero- external angle of the thin, oblong, though thoroughly ossified pars plana of the same side. In the coot the lacrymal is trian- gular for its lower portion—triangular and very thin—being produced as a spiculalike point below. It is separated by a | wide interval from the pars plana, or ethmoidal wing. The latter is a thin lamina of bone presenting several peculiarities. Its superoexternal angle is produced forward as a slender process in contact with the under surface of the frontal, while inter- nally, immediately below this same surface, an extensive elliptical foramen is formed for the passage of the nerve to the rhinal chamber.
In both the Porphyrio and the coot the interorbital septum is almost entirely lacking in bone, which also applies to the anterior cranial wall above and behind it. Both birds have the foramen rotundum circular and complete.
Porphyrio pulverulentus has the zygomatic bar very straight, rather broad, and transversely much compressed, rendering its upper and lower edges sharp.
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On the side of the cranium the crotaphyte fossa is well defined (Plate II, fig. 10), which is not the case in Fulica.
Both species have a pronounced postfrontal process, which points directly downward in either species; while in Fulica the squamosal process is spiculiform. In the Philippine gallinule it is broad and transversely flattened, constituting a cdnspicuous character of the side of the skull.
These birds have the osseous meatus of the ear very open, which admits, in the dried skull, of a complete view of the interior parts, the nature of the articulation of the head of the quadrate, the Eustachian passage, and other characters. This is also true of the coot; but in that bird the posterior wall of the osseous meatus is not nearly as much thickened, either relatively or actually, as it is in the big gallinule of the Philip- pines. Posteriorly, in either species, the supra-occipital prom- inence is conspicuously developed, and is not pierced by twin foramina as it is in many birds. A well-defined occipital ridge is present and very distinctly marked as a bounding line to this region. Above, on either side, the bounding line of the crotaphyte fossa runs into it; the points where the two lines meet it are 13 millimeters apart.
The external surface of the cranial vault is flatter than it _ is in the coot and presents a pair of parietal eminences placed side by side. Beyond this the frontal region, superiorly, is smooth and convex from before backward, merging gradually with the nasal on either side, but terminating abruptly and mesially in a transverse line over the premaxillaries; the latter are thoroughly united, with all sutural traces absorbed.
A quadrate has a large, inturned, blunt orbital process, with an extensive articulation for the mandible, it being triangular in form, with an articular, convex facet at each angle.
A pterygoid is short and not much twisted upon itself; it is broadened anteriorly, and the two bones meet in the median line, when normally articulated as they are in life.
The palatines are very intimately in contact in the median line, below the rostrum of the sphenoid, as far forward as the union with the bifurcation of the vomer, which latter fuses with them. The hinder part of either palatine below has an inner and an outer crest running forward and parallel with each other. Above, the broad orbital surface, however, is smooth and flat. Beyond this either bone mounds up in a peculiar way to meet the lower part of the ethmoidal wing and lacrymal bone of the same side. Still more anteriorly a palatine fuses with the maxillopalatine; the latter is separated from the fellow
XIV,1 Shufeldt: Osteology of Porphyrio 91
of the opposite side by quite an interval. The vomer is keeled inferiorly; it is slightly spreading above and is pointed at its free anterior apex.
Fulica has all of these bones far more delicately constructed and slenderer. In this species the prepalatines are extremely slender rods, the postpalatine parts being short, and far removed, on either side, from the pars plana. Moreover, a maxillopalatine is a shell-like bone, distinct from its fellow, being attached at the point of union of the zygoma, the nasal, the prepalatine, and the dentary part of the premaxillary. It is elliptical in outline, with its major axis parallel to the slender prepalatine, while its outer surface is concave, and the mesial correspondingly convex.
The external narial openings in the coot are very large and elongate, which is not the case in Porphyrio (Plate II, fig. 10).
As in many birds, the mandible is a V-shaped bone, with deep, thin rami and extensive symphysis in this species. There are no postarticular processes present; in fact, the hinder aspects of the articular ends of this mandible are substantially flat surfaces, only slightly concaved and lying in planes perpendi- cular to the long axis of the bone. The free margins, both above and below, are moderately rounded, while the dentary ones above are cultrate, terminating in a subacute apex anteriorly.
There are two foramina in either ramal part; that is, the usual splenial one, which is elliptical in outline, and another, smaller one, posterior to it, halfway between the first and the articular extremity, which is circular in outline.
Posteriorly, the ramal portion of the bone is thin, it being con- siderably heavier for its anterior portion. Most of the former moiety exhibits some pneumaticity, and this condition is present in a good part of the cranium and associated bones of the palatal region and face; it is also true of the ossa quadrata.
The ear bones have been lost.
In Fulica we also find a V-shaped mandible, with a number of its general characters agreeing with the corresponding ones in Porphyrio. The former, however, has the bone more elongate, narrower, and with a shorter symphysis. Finally, its ramal sides are not nearly so deep nor so thin. Then, too, in Fulica there is a special character not found in Porphyrio, which is well worthy of notice. It consists of little semicircular plates of bone attached, one on either side, just above the splenial foramen on the superointernal margin of the ramus. These platelets are directed horizontally and toward the median line. My im- pression is that each is covered with the horny theca of the
3 92 The Philippine Journal of Science 1919
lower jaw and is capable, in life, of being moved up and down in the vertical direction. They are not present in Porphyrio; and what their special function is in life is difficult to conjecture. (Specimen No. 19710, collection United States National Museum bird skeletons.)
The hyoid bones (Plate I, fig. 4) are extremely slender and elongate, and the glossohyal remains in cartilage throughout life, while the very minute urohyal is prolonged by a short, threadlike extension. This part of the skeleton of the coot at hand has been lost, so no comparisons can be made. It is fair to presume, however, that the skeletal parts of the tongue in these two birds are very similar.
The trunk skeleton—There are thirteen vertebre in the cervical division of the spinal column of Porphyrio wherein the pleurapophyses are not free; in the fourteenth they are small, and are found to articulate freely with the vertebra, while in the fifteenth each rib of the pair is long and as slender as a needle. They do not reach the sternum, nor are epipleural appendages present upon them. The fourteenth vertebra has some of the characters of a leading dorsal, and these are still more pro- nounced in the fifteenth vertebra (Plate III, fig, 11).
The cervical vertebre in Fulica are far more delicately fash- ioned than they are in the big gallinule of the Philippines. Proportionately, they are more elongate, with the pleurapophyses of the fourth to the eighth, inclusive, needlelike and long; in Porphyrio, relatively as well as actually, they are shorter and blunter. Only the second, third, and fourth have low, blunt, neural spines upon them, while in the fourteenth and fifteenth these processes are conspicuous and resemble the dorsal neural spines, only they are not so broad anteroposteriorly. Hzemapo- physes are present on the atlas and on the next two vertebrz behind it; they then disappear, to be seen again on the eleventh, twelfth, thirteenth, and fourteenth, where they are thin lamine of bone in the median line and transversely compressed.
The carotid canal is open for its entire length; while the vertebral canal, on either side, is completely surrounded by bone in the third to thirteenth cervicals, inclusive.
In both Porphyrio and Fulica the first two dorsal vertebrz possess hemal spines resembling those of the cervical vertebre; they are short and transversely compressed. On the other hand, all of the vertebre in this division of the spinal column possess very large, thin, quadrilateral neural spines, which increase in size from first to last as we proceed in the anteroposterior direc- tion. Their free superior margins are slightly thickened; and
ee +, A) Shufeldt: Osteology of Porphyrio 93
from the second to the eighth dorsal vertebra—the latter the last of the series—they are in contact at all of their superior angles, each vertebra with the one next behind it. The anterior and posterior margins of these neural spines: are concave in outline and sharp. This, in the articulated skeleton, leaves elliptical vacuities among them (Plate III, fig. 11). There are linking metapophyses on the superior outer extremities of the transverse processes of all these dorsal vertebre; while in Fulica the neural spines above are lashed together through the ossifi- cation of the tendons of the muscles of the back.
As will be noted from Plate III, fig. 11, of the present article, the dorsal ribs of Porphyrio are long and slender, as in the case of all true coots and gallinules, with costal ribs, or hemapo- physes, to correspond with them. The leading five support epi- pleural appendages—six in Fulica. There is always a pair of slender pelvic ribs; but the costal ribs of this pair do not articulate with the sternum.
The pelvis.—Porphyrio has a pelvis that is shorter and broader than it is in Fulica and in the gallinules—relatively with respect to the latter and actually with respect to the former. This increased breadth is especially marked in the postacetabular ‘portion of the bone; it is also of denser and heavier build in the big gallinule of the Philippines than in the other forms mentioned.
The preacetabular portion is elongate, narrower, and markedly concaved on the external iliac surfaces, which in Porphyrio fuse with the superior margin of the presacral vertebre for its full length, completely closing up the iliac-neural posteriorly. Curiously enough, in the coots and gallinules the inner margin of the middle third of the preacetabular part of either ilium is concave and sharp, thus sweeping below the superior margin of the sacral crista, between the anterior third of the crest and the posterior, which latter is opposite the acetabule. At this interval the inner margins of the ilia are not in contact with
* When the present paper had been finished up to this point, there came to hand a “complete” disarticulated skeleton of a Gallinula (No. 18889, United States National Museum). It is from an adult individual collected by Dr. W. L. Abbott on Ile St. Louis, of the Seychelles. The skull, hyoid arches, vertebre, and ribs in this species of gallinule resemble those parts of the skeleton in Fulica more than they resemble the corresponding bones in the skeleton of Porphyrio. It is to be noted, however, that the curious processes on the mandible found in Fulica are not present in this Gallinula; while the cranium, on the other hand, agrees in all respects with that of Fulica, and consequently exhibits the same differences when we come to compare it with the cranium of Porphyrio.
94 The Philippine Journal of Science 1919
the sacral crest, a little open slit being present as a consequence; this is also the arrangement in Gallinula. In most respects, the postacetabular portion of the pelvis in this Gallinula agrees in its characters with the corresponding ones as we find them in Porphyrio. There are two striking characters, however, which agree, upon comparison, in Fulica and Gallinula and depart from the corresponding ones in Porphyrio; they are these: The posterior-inferior angle of the ischium in the coot and in the gallinule is drawn downward and outward as a conspicuous process; this angle is truncate in Porphyrio. Again, the distal free extremity of the postpubic rod in Fulica and in Gallinula is bent downward at an angle with the rest of this rod, the bending taking place at a point opposite the posterior-inferior angle of the ischium of the same side. Turning to the skeleton of Porphyrio, we note that this angle of the ischium on either side is truncated, and that the postpubic rod is not bent at any part of its length (Plate III, fig. 11).
In all the species of this coot-gallinule group of birds there is a very remarkable character on the inferior side, or ventral aspect, of the hinder part of the pelvis; it consists of a deep, pocketlike recess, or concavity, apparently formed by the exten- sion, on either side, of the ischium. Mesiad, it thoroughly cods- sifies with the last three vertebre of the pelvic sacrum, and its anterior free margin beneath is sharp and concave in outline. The completed osseous pockets thus formed are deep and capa- cious, occupying very nearly one-half of the postacetabular con- cavity of the pelvic basin. Each extends as far forward as the posterior margin of the rather large subcircular ischiadic fora- men on either side.
There are seven small free caudal vertebre in Porphyrio to eight in F'ulica. In addition to these in each bird there is a more or less inconspicuous quadrilateral pygostyle. When duly artic- ulated, these vertebree form an arc, which is concave along its superior line (Plate III, fig. 11).
The shoulder girdle and sternum.—tThere is a great similarity in the characters with respect to all the bones of this part of the skeleton in the bird forms referred to in the present paper.
In Porphyrio a scapula, in the articulated skeleton, reaches almost as far back as the pelvis; it is narrow, flat, pointed, and markedly curved, being convex along its inner border and correspondingly concave along its outer one. In Fulica this is much narrower, longer, and less curved and does not seem to articulate with the os furcula, whereas it does so, extensively, in Porphyrio.
XIV, 1 Shufeldt: Osteology of Porphyrio 95
A coracoid in our present subject is a stout, straight bone, much expanded for its sternal moiety, which part is concave posteriorly and nearly flat anteriorly. As in Fulica and Galli- nula it develops a sharp process at the outer inferior angle of its shaft, and the two bones in none of these genera meet in the coracoidal groove of the sternum in the articulated skeleton. All three bones of the arch assist in forming, superiorly, the “tendinal foramen.” The very delicately formed “fourchette” is a U-shaped bone in all of these paludicoline birds (Plate III, fig. 11), and lacks anything like a hypocleidium. At the median point of the arch below, however, there is usually developed a minute process on the upper side, directed upward.
None of the bones of the pectoral arch in any of these genera is pneumatic, which is also true of the sternum; in fact there is little or no pneumaticity of any part of the skeleton, as we find it among the various genera of the marsh birds. Indeed, this is what we would expect in the case of fowls that make so little use of such powers of flight as they possess.
There is no mistaking the sternum of any species of this in- teresting group, and the characters of the bone are much the same throughout. The anterior border of the keel in Porphyrio slopes away posteriorly, more than it does in Gallinula and the coots; but beyond this the differences are barely of generic rank (Plate III, fig. 11).
The sternal body is narrow and much concayved on its dorsal aspect. Markedly prominent, the quadrilateral “costal proces- ses” are flaring and truncated superiorly. A very small manu- brium is present, and the costal grooves are practically con- tinuous with a median notch above them on the superior border.
The “carina” is well developed, being concave on its anterior border and convex on its inferior, the “carinal angle” being acute. There are six articular facets upon either costal border in Porphyrio and Fulica, but apparently only four or five in the Gallinula from the Seychelles Islands.
The midxiphoidal process, with the carina running the entire length of it on its ventral aspect, is bluntly pointed posteriorly, and an isosceles triangle in outline, the somewhat blunt angle being acute.
This xiphoidal portion of the bone is profoundly one-notched upon either side; the notch being triangular, with the angle pointing anteriorly. This gives rise to a long, lateral xiphoidal process on either side; each process is narrow, of uniform width, and somewhat expanded at its free extremity. Plate II, fig. 7, gives some idea of the ossifications that take place in
" 162323-——-7
96 The Philippine Journal of Science 1919
trachea; they are quite ordinary, which is likewise true of such ossifications as are met with in the larynx.
The pectoral limb.—All the bones of either limb in Porphyrio are entirely nonpneumatic, and this is apparently the case in Fulica, Gallinula, and their near congeners in various parts of the world. In Gallinula, when the skeleton is carefully cleaned and bleached, the humeri—as is the case in all the bones—are extremely light and creamy white; but they present no pneu- matic foramina at the sites where, when present, they occur in the vast majority of birds. All the bones of the limbs in Porphyrio, even when carefully prepared, are dark and greasy— at least this is the case with those before me, and they were prepared at the United States National Museum.2
In their morphology the pectoral limb bones in Porphyrio and Fulica americana are wonderfully similar, the several bones being somewhat shorter and correspondingly slenderer in the latter species. The humeral shaft in the coot is a shade stouter. In Porphyrio the bone has an extreme length of 7.8 centimeters; in Fulica, 7.5 centimeters. Were these two bones found fossil, they would never be described by any com- petent avian paleontologist as having belonged to represent- atives of different genera. In the humerus of the coot the pneumatic fossa is deeper and somewhat more circumscribed ; and this, apart from the difference in length, is the only distin- guishing character of any consequence.
The form of the humerus in Porphyrio is well shown in Plate I, figs. 1 and 6. It will be noted that the radial crest is very low (fig. 6); and the notch, or valley, between the humeral head and the thickened proximal portion of the ulnar crest overarching the pneumatic fossa is notably deep and character- istically conspicuous, ;
Radius is nearly straight and inclined to be slender, while the ulna exhibits considerable curvature, thus insuring, in the articulated skeleton, a rather broad “interosseous space.”
Radiale and ulnara of the carpus present the usual ornithic characters and articulations. The shafts of the carpometacarpus are long and slender (fig. 1), and the pollex phalanx supports a free claw at its distal end; but no such claw occurs on the terminal phalanx of the index digit.
The general characters of the pelvic limb may be well seen in Plate II, fig. 8.
*I am inclined to believe that Mr. Scollick made no attempt to degrease | or bleach this skeleton.
XIV, 1 Shufeldt: Osteology of Porphyrio 97
The head of the femur is very small in proportion to the size of the remainder of the bone; and the pit for the ligamentum teres is extensive and rather deep. Rising somewhat above the summit of the bone, the trochanter major is very broad across its outer aspect. While bowed to the front, the shaft of the bone has a curious though very slight turn in it about its middle (fig. 8). Distally, the condyles are large, and the fibular notch in the outer one is notably deep. As a matter of fact, the skeleton of the pelvic limb of Porphyrio is not only big-boned for the size of the bird; but the individual bones are long, with conspicuous characters at their extremities. No patella is to be seen in this limb, and this is also true of the coots and gallinules.
Porphyrio has a very long tibiotarsus as well as tarsometa- tarsus, and this is also true of the joints of pes (Plate IT, fig. 8). In the first-named segment of the skeleton of the leg, the cnemial process is rather conspicuously developed, it being confined to the upper part of the shaft. The “ectocnemial projection” ter- minates in a little hook at its lower angle. Fulica has the en- tocnemial process wonderfully developed; it not only rises well above the summit of the shaft of the bone, but also projects far forward and to some extent downward. Often the fascia at- tached to its inferior border ossifies to some considerable extent, especially the outer margin of it, running into the antero-inner surface of the shaft at a point below the “fibular ridge” on the other side. The “ridge” referred to is well developed in all of these paludicoline birds, distinctly so in Porphyrio, while in it, as in all of them, the fibula is very weak, and partly ligamentous below its articulation with this projection. At the distal end of the tibiotarsus, on the anterior aspect, we may note above the condyles the usual ossified tendinal bridge crossing the longitud- inal groove in that locality. eb
Taking the unusual development of the proximal extremity of this bone into consideration, it is worthy of note that the condylar end is, relatively speaking, not so markedly enlarged; that is, the condyles, though of good size, are not strikingly bulky. As is usually the case, the outer one is the larger and the rounder in outline, and, anteriorly, the thicker in its trans- verse diameter. To some extent they project beyond the surface of the shaft, posteriorly, thus continuing the intercondylar valley in that locality.
Hypotarsus of the tarsometatarsus is well developed, but in Porphyrio appears to be neither grooved nor pierced for the passage of tendons. It is both once-grooved and once-pierced
98 The Philippine Journal of Science 1919
in Fulica and in Gallinula, though feebly so in either case. Por- phyrio has simply a shallow, central depression there to guide the passage of the tendons of the muscles coming down from the leg.
. Our big gallinule has the shaft of the long tarsometatarsus somewhat flattened on its anterior and posterior aspects, and these surfaces are strongly grooved for their entire lengths, particularly on the hinder aspect, where the tendinal gutter runs the entire length of the straight shaft of this element of the pelvic limb.
A large accessory metatarsal is present, being hinged to the shaft by strong ligament at its usual site in ordinary birds; it © supports the big phalanx and claw of hallux. All the other phalangeal joints of the three anterior toes of pes are lengthy and of considerable caliber, as will be seen by referring to Plate II, fig. 8.
This brief review of the osteology of Porphyrio shows it to be a form possessing many of the characters of the typical paludicoline fowls; at the same time it exhibits not a few others that are distinctly generic in kind, especially those that have been described above as pertaining to the skull and to the pelvis.
NOTES ON THE OSTEOLOGY OF TACHYBAPTUS PHILIPPENSIS (BONNATERRE)
Early in August, 1917, when Mr. McGregor sent me the skele- tons of Porphyrio pulverulentus, he also sent for my examination rough skeletons of Tachybaptus philippensis (Bonnaterre) and Hydrophasianus chirurgus (Scopoli); one each of these two species has been cleaned for me by Mr. Scollick, of the United States National Museum, an assistance for which I have to thank Dr. James E. Benedict, chief of exhibits of that institution. When Mr. McGregor sent me these skeletons, he also included brief life histories of Tachybaptus and Hydrophasianus, which I may some day use in another connection; the present brief notes refer, as their title indicates, simply to their osteology.
The specimen of Tachybaptus philippensis, an adult male from Paete, Laguna, Luzon, P. I.; March 26, 1917 (McGregor), is No. 226033, United States National Museum. The entire skele- ton of this bird presents the characters of those found in that part of the anatomy of any small average grebe. Indeed, they are quite typical, as I find to be the case upon comparing the various bones with the corresponding ones in the skeleton of Podilymbus podiceps (No. 17272, United States National
XIV, 1 Shufeldt: Osteology of Porphyrio 99
Museum) and those of Colymbus cornutus (No. 17873, United States National Museum).
Taken as a whole, the skull of Tachybaptus agrees much better with the skull of Colymbus than it does with that of Podilymbus—a fact due principally to the shortening and broad- ening of the superior mandible and jaw in the latter form. The space between the superior peripheries of the orbits in the frontal region is quite as broad in the Philippine grebe as in the dabchick, while in the horned grebe it is much narrower.
Tachybapius presents a peculiar character in the pterygoids not to be found in the skulls of the two species with which it is here being compared; this consists in their being, in the case of either pterygoid, gradually broadened out by thin lamine that pass from the quadrate end to the palatine of the same side, the broadest part being the distal third. In Colymbus these bones are very slender rods, with scarcely a trace of laminar expansion.
The hyoid arches seem to have been lost in these skeletons except in Tachybaptus, where they have been preserved with the trachea. The glossohyal is rather short and broad, the urohyal being very slender. The hypobranchials are long, and the ceratobranchials very short, while the two together are reduced almost to hairlike proportions, so exceedingly slender are they in caliber.
Throughout its length the trachea is simple in structure, and the numerous rings are entire and thoroughly ossified from first to last.
The true grebes seem to possess eighteen cervical vertebre in the spinal column to seventeen of Podilymbus; possibly one may have been lost in the skeleton of the latter bird at hand, but I am inclined to think not.
Tachybaptus has the first pair of ribs on the nineteenth ver- tebra; they are without costal ribs, though the epipleural ap- pendages are well developed and long. These do not ankylose with their ribs anywhere in the series, and they are found upon the next following four pairs of ribs, all of which latter have true costal ribs. There are two pairs of pelvic ribs; the first pair reaches the sternum through costal ribs, while the second does not. Behind these a very delicate pair of floating hzema- pophyses is seen. None of these possess unciform appendages.
We find the same arrangement in Podilymbus podiceps, while in Colymbus cornutus there are nine pairs of ribs, the leading seven pairs having unciform processes. The first two pairs do not possess costal ribs; and the last two pairs, which are pelvic
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ribs, are without appendages. Only the first pair of these pelvic ribs has costal ribs, while an aborted floating hzmapophysis, long and slender, completes the series.
Morphologically, the grebe’s pelvis is well known—compar- atively speaking as well as actually; it is shorter in Tachybaptus than in either Colymbus or Podilymbus; in the latter genus it is extremely long and strikingly narrow. Nothing of particular note marks the small caudal vertebre in this little grebe of the Philippines.
In regard to its shoulder girdle, or pectoral arch, it comes nearer Podilymbus than it does to Colymbus, especially in the matter of the U-shaped furcula; for there is no hypocleidium present except in the case of Colymbus cornutus, where it is a well-developed peg of bone directed backward.
The sternum presents all the usual characters as we find them in the grebes generally; it is nonpneumatic, and the mid- xiphoidal notch is notably shallower than in the dabehick and most other American grebes. This is also true of the lateral sternal notches, while the lateral xiphoidal processes are stouter and shorter than we find them among the birds last mentioned.
As among the Colymbide generally, the long bones of the arm and hand in Tachybaptus are completely nonpneumatic, while in form they are long and slender. While the usual “sigmoid curve” is to be seen in the humerus, it is not nearly as well marked as we find it in many other groups of birds. Then, too, the general characters of the proximal extremity of the bone are more or less feebly developed—a fact that causes no‘surprise, in as much as these birds are feeble fliers as com- pared with many other aquatic species. There are no claws on the phalangeal joints, and the carpometacarpus is long and slender.
Judging from appearances in the prepared skeleton, it would seem that the femur and the superior halves of the bones of the leg might be to some extent pneumatic, which is not the case in the grebes found in North America. Otherwise, the morpho- logy of this part of the skeleton in Tachybaptus is entirely in agreement with that of any small grebe; this especially applies to the patella and other features of the knee joint. As in other grebes the inner trochlea of the tarsometatarsus is situated pos- teriorly on the shaft of the bone, and the accessory metatarsal, with its joint and claw (hallux), is found well up the shaft above it. The ungual joint of the midanterior toe is much expanded and shell-like, while in the case of those of the other
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XIV, 1 Shufeldt: Osteology of Porphyrio 101
two toes, though thin and flattened, they are no wider than the joint next behind them in the case of’ either toe; this is also characteristic of the American grebes.
NOTE ON THE SKELETON OF HYDROPHASIANUS CHIRURGUS (SCOPOLI).
Hydrophasianus possesses no special osteological characters not found in any typical. jacana; as, for example, in Jacana spinosa (Linnzus), the Mexican jacana. This is what we would look for, in as much as it is but a good average representative of the Jacanidz of the world’s avifauna.
Its skull is to some considerable extent pneumatic, including the mandible, while no other part of the skeleton enjoys that condition. There is an unusual resemblance in its skull to some of the sandpipers, and, to a slighter degree, this is likewise to be observed in the remainder of the skeleton; though this does not apply, to be sure, to the greatly lengthened digits of pes.
The sternum is somewhat narrow and elongate, being pro- foundly once-notched on either side, which gives rise to long, slender xiphoidal processes, and a rather broadish midxiphoidal part with slightly projecting outer angles.
As the skeleton of this species has probably not been heretofore figured—and certainly not from a photograph made direct from the dried skeleton—I am here giving sych a plate, which I per- sonally prepared from the skeleton forwarded me by Mr. Richard C. McGregor, and which now forms a part of the collection of bird skeletons in the United States National Museum.
ILLUSTRATIONS
{All of the figures of the plates are of natural size and are reproduced from the author's
HIG: . 1.
a Laie
10
photographs made direct from the specimens.] PLATE I
Left pectoral limb of Porphyrio pulverulentus Temminck, seen upon palmar aspect. The bones figured on Plates I to III illustrating this paper are all from the same _ individual. Adult male, No. 226035, collection of the United States National Museum. Paete, Laguna, Luzon, P. I.
. The mandible of Porphyrio pulverulentus, dorsal view. . The skull of Porphyrio pulverulentus, superior aspect. See Plate
Il, fig. 10.
. The hyoid arches seen from above; the cartilaginous parts of
the glossohyal have been allowed to remain by the osteologist who prepared the skeleton at the United States National Museum.
. The first eight cervical vertebre of Porphyrio pulverulentus,
normally articulated and seen from above.
. The right humerus seen upon anconal aspect.
PLATE II
Right lateral view of the trachea of Porphyrio pul. erulentus, with the bronchial extremity and a few rings above it removed.
. Left pelvic limb of Porphyrio pulverulentus seen upon outer aspect.
The patella does not exist in this species, its place being taken by a strong fibrous ligament.
. The leading eight cervical vertebre of Porphyrio pulverulentus
seen from below; they are normally articulated as in life, and the upper view of them is shown in Plate I, fig. 5.
Right lateral view of the skull of Porphyrio pulverulentus, with mandible dissociated. See Plate I, figs.