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September 1, 1923


Author Affiliations

From the Departments of Pathology and of Medicine, of Lakeside Hospital and Western Reserve University.

JAMA. 1923;81(9):719-723. doi:10.1001/jama.1923.02650090017005

Evidence is accumulating that pulmonary gangrene may be caused by spirochetes and fusiform bacilli aspirated from an unclean mouth, and that it may be prevented by proper oral hygienic measures. Furthermore, when the condition is once established, diagnosis can be made early by finding the organisms in the washed sputum, thus offering an opportunity for successful specific treatment with arsenic.

Little attention was paid to the possible etiologic relationship of spirochetes to bronchopulmonary lesions until 1906, when Castellani reported from India two cases of hemorrhagic bronchitis simulating pulmonary tuberculosis but caused by spirochetes. To the condition he gave the name bronchial spirochetosis. A year before, Rona, in Germany, in a report concerning spirochetes and fusiform bacilli, included a postmortem study of two cases of pulmonary gangrene; in one, numerous spirochetes and fusiform bacilli were found, and in the other, sections of the gangrenous lung showed many fusiform baccilli. In this

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