野口英世著

Journal of Experimental Medicine

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T H E S P I R O C H E T A L FLORA OF T H E N O R M A L
GENITALIA.

FEMALEBY HIDEYO NOGUCHI, M.D.,,AI~I~DAVID J. KALISKI, M.D.

(From the Laboratories of The Rockefdler Institute for Medical Research.)
l~Aa'~ 57.
(Received for publication, June 27, 1918.)
The present paper is a sequel to a recently published 1 study of thespirochetal flora of the male genitalia. The subject has been takenup, not because there was any reason for supposing the spirochetal
flora of the female genitalia to be different from that of the male,but because of the relative infrequency of any special reference to the,former in literature, and in order to obtain more accurate knowledge
concerning it. Except for the occurrence of the well known Spironema refringens (Schaudinn and Hoffmann ~) in both male and female
genitalia, practically nothing is known about the spiral organisms in
the normal female genitalia.
On anatomic and physiologic grounds the female genitalia undoubtedly afford more favorable conditions for the existence of thesesaproph)~tic spirochetes, and the results of examinations of thesmegma, films, and washings of the genital mucous membranes ofnormal adult females conclusively demonstrate that the number ofspirochetes of the female is much greater than that of the adult male,although the varieties present appear to be identical in both. As in
the male smegma Treponema catligyrum is encountered here also as
tl~e predominating variety in the majority of specimens, while Treponema minutum is present almost constantly but in fewer numbers.
On the other hand, the coarse Spironema refringens has been lessfrequently met with here than in the male smegma. The finding
may have been accidental but is recorded here for future reference.
I Noguchi, H.: The spirochetal flora of the normal male genitalia, J. Exp. Med.,
1918, xxvii, 667.
2Schaudinn, F., and Hoffmann, E., Arb. k. Gsndhtsamte., 1905, xxii, 527.
559

560

SPIROCHETALFLORA OF NORMAL FEMALE GENITALIA

The morphologic and cultural characteristics of these three types
were described in a previous publication. 1 In Figs. 1 to 8 calligyrum,
minutum, and refringens are easily distinguished. The organisms
stained by Fontana's method (Figs. 1 to 3) appear more distinctly
than those stained by the mordant gentian violet method (Figs. 4 to8), but in either case there is no difficulty in recognizing the types.
Here, as with the male smegma, the use of the dark-field microscopeis important in order to avoid confusion of the organisms belonging
to the Leptospira group with those normally present.
Examination of the spirochetal flora of female children up to theage of 2 years showed that the varieties present are similar to thosefound in the adult, differing from the latter only in being lessnumerous.
CONCLUSION.
The spirochetal flora of normal female genitalia is similar to thatof the male and consists of Treponema calligyrum, Treponema minutum, and Spironema refringens. The types are present in varying
proportions, but the calligyrum usually predominates, and the refringens is the least frequent. The female genitalia are much richer
generally in the number of spirochetes than the male.
EXPLANATION OF PLATE 57.
Magnification, X 1,000.
FIGS. 1 to 3. Films from female smegmas, showing TreponemacalHgyrumand

Treponemaminutum.
FIG. 4. Several specimens of Treponema calligyrum and a few of Spironema

refringens.
FIG. 5. Several specimens of Treponema calligyrum and one of Treponema

minutum.
FIo. 6. The three types.
FIGS. 7 and 8. Treponemacalligyrumand Treponemaminutum.

THE JOURNAL OF EXPERIMENTAL MEDICINE vOL. X X V I I I .

PLATE 57.

(Noguchi and Kaliski: Spirochetal flora of normal female genitalia.)