The Flagellata observed by Ekeckrantz (1869) in the intestine of man belong to this form—at least to the larger variety—and Tham (1870) reported fresh cases soon after. Lambl’s publication of 1875, which was written in Russian, and became known through Leuckart’s work on parasites, also alludes to apparently typical Cercomonads, which, however, were discovered, not in the intestine, but in an Echinococcus cyst in the liver (fig. 22). The elliptical, fusiform, rarely pear-shaped or cylindrical bodies of the parasites measured 5 µ to 14 µ in length, and were provided with a flagellum at one end, while the other extremity usually terminated in a long point. An oral aperture occurred at the base of the flagellum, and there were one or two vacuoles near the posterior extremity. Longitudinal division was also observed (fig. 22).
As already mentioned, this form, which Lambl termed Cercomonas intestinalis, differs considerably from the form found by the same author in 1859, which received the same designation (cf. Lamblia intestinalis, p. 60), but it corresponds with Cercomonas hominis, Davaine. The latter, as well as C. intestinalis, Lambl, 1875, is usually classed with the Trichomonads, but, as has already been remarked (cf. Trichomonas intestinalis, p. 54), this cannot be considered correct, as only one flagellum is present.
Cercomonas vaginalis (Castellani and Chalmers, 1909) was found in the vagina of native women in Ceylon.
Other species of Cercomonas have, at various times, been recorded from man. However, the parasitic species of the genus Cercomonas require further investigation.
According to Janowski (1896–7), typical Cercomonads have also been observed in the intestine of man by Escherich, also by Cahen, Massiutin, Fenoglio, Councilman and Lafleur, Dock, Kruse and Pasquale, Zunker, Quincke and Roos, and others. However, it is an open question whether the Flagellata observed by Roos in one of his cases belonged to Davaine’s species, the size showing some deviation (14 µ to 16 µ). In his, as in many other cases, doubts have been raised as to whether the flagellates found in the stools had actually lived in the intestine, or had subsequently appeared in the fæces: for this a surprisingly short time only is necessary. Salomon also appears to have observed Cercomonads (Berl. klin. Wochenschr., 1899, No. 46).
As with T. intestinalis so with C. hominis, it appears that the parasite settles not only in the intestine but also in the air-passages. This is demonstrated by the statements of Kannenberg and Streng of the occurrence of Monads and Cercomonads in the sputum and putrid expectoration in gangrene of the lungs, which no doubt apply to C. hominis (cf. also Artault). Possibly also the Flagellata observed in the pleural exudation by Litten and Roos may be included here; this is the more probable in Roos’s case as the process ensued in the pleura after the breaking through of a vomica.
Perroncito and Piccardi have described encysted stages of Cercomonads.
Fig. 23.—Monas pyophila, R. Blanch. (After Grimm.)
Monas pyophila, R. Blanch., 1895.
R. Blanchard thus designates a Flagellate that Grimm found in the sputum, as well as in the pus of a pulmonary and hepatic abscess, in the case of a Japanese woman living in Sapporo. The parasites resemble large spermatozoa (fig. 23). The body, 30 µ to 60 µ, has the shape of a heart or a myrtle leaf, and is surrounded by a thick cuticle which is supposed to extend into the interior of the body, dividing it into three parts. A long appendix at the rounded pole is covered for the greater part of its length by the cuticle; the extremity, however, is free and resembles a flagellum. The parasites were very active, frequently changed their shape, and were able to retract the long appendix within the body, which then assumed a round form.
[This organism requires further investigation.]
Family. Bodonidæ, Bütschli.
Protomonadina which are either free-living or parasitic, with two dissimilar flagella, while the possession of an undulating membrane and of a kinetic nucleus or blepharoplast is variable.
There are three genera:—
1. Bodo, Stein, 1878, without a kinetic nucleus and undulating membrane.
2. Prowazekia, Hartmann and Chagas, 1910, with a kinetic nucleus and without an undulating membrane.
3. Trypanoplasma, Laveran and Mesnil, 1901, with a kinetic nucleus and undulating membrane.
Of these genera Prowazekia must be discussed. Bodo does not occur in man. Species of Trypanoplasma occur in the blood and in the gut of various fishes, in the seminal receptacle of certain snails, in the gut and genitalia of a flatworm (Dendrocœlum lacteum) and in the vagina of a leech. Closely allied to Trypanoplasma is the genus Trypanophis, parasitic in the cœlenteric cavity of Siphonophores.
Genus. Prowazekia, Hartmann and Chagas, 1910.
The genus was founded for a flagellate parasite, Prowazekia cruzi, discovered in a culture of human fæces in Brazil. Various other species have been referred thereto. The genus is separated from Bodo by the possession of a second nucleus, the so-called kinetonucleus or blepharoplast. It differs from Trypanoplasma in the absence of an undulating membrane. It is heteromastigote, that is, it possesses two dissimilar flagella, one anteriorly directed and the other lateral and trailing.
The principal species are:
Prowazekia urinaria, Hassall, 1859.
Syn.: Bodo urinarius, Hassall, 1859; Trichomonas irregularis, Salisbury, 1868; Cystomonas urinaria, Blanchard, 1885; Plagiomonas urinaria, Braun, 1895.
Hassall47 in 1859 first found Bodo-like flagellates in human urine. He examined fifty samples of urine from patients suffering from albuminuria and from cholera. The reaction of the urine was alkaline or sometimes only feebly acid. The flagellates were only seen after the urine had been standing for several days. Hassall named the organism Bodo urinarius, and gave a very good description of it with illustrations. The flagellate, which was round or oval, measured 14 µ by 8 µ. The organism had “one, usually two, and sometimes three lashes or cilia.” In 1868 Salisbury described a similar flagellate in the urine under the name Trichomonas irregularis. Künstler in 1883 described the latter parasite under the name B. urinarius. In 1885 Blanchard, considering Künstler’s organism a different parasite from Hassall’s, called it Cystomonas urinaria. Braun, in 1895, gave the name Plagiomonas urinaria. Barrois (1894) considered Künstler’s and Hassall’s organisms to be identical and not to be true parasites of man. Sinton,48 in 1912, found the flagellate in the deposit, after centrifuging, of a 24-hour old specimen of alkaline urine from a Mexican sailor in the Royal Southern Hospital, Liverpool. Sinton found a kinetic nucleus or blepharoplast in the organism, and therefore placed it in the genus Prowazekia.
Fig. 24.—Types of Prowazekia urinaria. (a) sausage-shaped; (b) round; (c) carrot-shaped form. (After Sinton.)
The flagellate stage (fig. 24) of the organism is polymorphic, and may be either (a) sausage-shaped, 10 µ to 25 µ in length by 2·5 µ to 6 µ in breadth; (b) round or oval, varying from 4 µ in diameter to oval forms 15 µ by 10 µ; (c) a carrot-shaped form, of varying size up to 25 µ by 4 µ. The kinetic nucleus is large and pear-shaped. Near it are basal granules, closely applied to one another, from which the flagella arise. There is a small cytostome near the roots of the flagella. There is a well-marked karyosome in the nucleus. The movement is jerky. The shorter, anterior flagellum may be used in food-capture. In life, bacteria have been seen to be ingested. Food-vacuoles