Saprophytes

SAPROPHYTES (from Greek sapros-rotten and phyton-plant), microbes that feed on dead organic matter and are contrasted with parasites that live in (or on) organisms and feed on living organic substrate. Saprophytes are widely distributed in nature, occurring in soil, water, etc., as well as in the human and animal organism, where on the surface of the body and in its cavities they find the necessary nutritional material for themselves. It can be considered highly probable that parasites originated from saprophytes by adaptation to conditions of existence in the animal organism. In favor of this speaks the fact that between saprophytes and parasites there exists close relationship, and to any parasitic species of microbes there corresponds a more or less extensive group of saprophytic forms; thus, the tubercle bacillus has close relationship with acid-fast saprophytes widely distributed in soil, water, on stems of grasses, etc.; alongside the parasite-the cholera vibrio-there exist many species of cholera-like microbes living mainly in water; to the parasite-the diphtheria bacillus-correspond saprophytes-diphtheroids, etc. Saprophytes usually are non-pathogenic microbes, but the line in this respect between them and pathogenic microbes-parasites is not always drawn sharply enough. On one hand, there occur microbes that lead a saprophytic way of life but nevertheless possess pathogenicity; thus, the botulism bacillus is a saprophyte, but, by excreting toxin, it can cause a fatal disease for humans. On the other hand, harmless to humans or animals saprophytes can under certain conditions acquire pathogenic properties. So-called microbes de sortie are normal inhabitants of the animal organism and non-pathogenic: under certain conditions however they become the cause of diseases. Examples of saprophytes acquiring pathogenic properties can be cited many; thus, diseases of humans are described caused by the following saprophytes: the bacillus of pseudotuberculosis of rodents (otitis media purulenta), the colon bacillus (pyelocystitis), the pseudomonas bacillus (meningitis), Bac. subtilis (intestinal form of pseudoanthrax), the proteus (general sepsis, meningitis), etc. Of the artificial transformation of saprophytes into pathogenic microbes many authors report. Thus, Uhlenhuth and Zuelzer succeeded in transforming the water spirochete into Sp. icterogenes; Kolle, Schlossberger and Pfannenstiel described the transformation of various acid-fast saprophytes into an acid-fast bacillus close in its properties to the true tubercle bacillus; Zlatogorov from the bacillus of pseudotuberculosis of rodents obtained a microbe approaching in its properties to the plague bacillus; Eisenberg obtained a variety of Sarcina tetragenes, proving to be virulent for mice and guinea pigs, etc. Not all these observations are impeccable (e.g. the observations of Kolle, Schlossberger, Pfannenstiel), but this does not however allow to deny the possibility of saprophytes acquiring pathogenic properties. Being widely distributed in nature, saprophytes also occur in large numbers in the human organism, inhabiting in it cavities communicating with the external air; a large number of saprophytes is contained in the cavity of the intestine, they are also found in the mouth, in the vagina, etc. The question of the interaction of saprophytes and parasites in the natural conditions of their existence is little studied. Recent works (Zilber) indicate that on saprophytes one can grow filterable microbes.

V. Lubarsky. SARCOIDS. At the present time into the group of sarcoids (see Boeck's sarcoid and Lupoid) are included those connective tissue neoplasms which clinically express themselves in the form of nodosities of various size, very often, but not always multiple, almost completely painless, with extremely slow course. They differ in benignity in that they have very little tendency to ulceration, do not metastasize, do not cause any considerable disorders of general nature, are prone to retrogressive development and submit to therapeutic measures. Subcutaneous sarcoids were described Darier together with Russi in 1904-06. This form is characterized by the presence of neoplasms without subjective sensations; they appear non-inflammatory, chronic or subacute, of various size-from a pea to a walnut; in some cases they are located isolated, in others they merge, forming rather extensive, uneven plaques, sometimes arranged in the form of as it were cords. Over these neoplasms the skin is either movable or adherent, then of normal color then cyanotic-rose-colored. They are sometimes arranged symmetrically, are localized more frequently in the region of the shoulder blades, on the lateral surfaces of the trunk, on the anterior surface of the thighs and lower part of the abdomen, but can be located also in other places. They occur in adults, more rarely in children, in general equally often in men and women. They can stretch for quite a long time. Histologically, according to Hans, in general a very similar picture to other sarcoids is found. In some cases typical tuberculoid structure is present, in others banal infiltrate which is located mainly in the subcutaneous fatty tissue, but extends in the form of processes also into the dermis. The infiltrate consists mainly of lymphocytes, young connective tissue cells, epithelioid and giant cells and is arranged in the form of tubercles. Changes in the vessels and fatty tissue almost completely correspond to what is observed in erythema induratum of Bazin (see Bazin's erythema indurativa). Scattered nodular sarcoids morphologically represent more or less large nodes, erupting in attacks, symmetrically located mainly on the extensor surface of the extremities in the number of 10 and more. The skin has normal or cyanotic-rose color. These nodes are very rarely painful, then very dense then somewhat pasty. They very rarely erode; they are observed in persons of both sexes at any age. Histologically, as well as clinically, very close to the above described form. In the process the subcutaneous fatty tissue and deeper layers of the dermis are involved. As in Bazin's indurated erythema, the starting point of the changes is the vascular system. Along with this in the fatty tissue and in the connective tissue septa small necrotic foci are found. The infiltrate consists of lymphocytes, fibroblasts, epithelioid and giant cells. Sometimes there is expressed tuberculoid structure and so-called Wucheratrophie. In the differential diagnosis of both varieties of sarcoids first of all one has to think of tumors, from which these sarcoids differ by the character of development and structure. At some places they can give occasion for confusion with adenopathies. Besides this one has to keep in mind gummas and nodes caused by injections. The origin of sarcoids cannot yet be considered quite clarified; at the same time it is finally known that sarcoids represent a neoplasm of inflammatory character, not tumors. They are formed as a result of embolism of vessels and are a consequence of infection. For this speaks the character of their structure, development, predominant location near vessels. A whole series of facts forces to consider them in connection with tbc and to consider them in the vast majority of cases as tuberculides (Jadassohn, Kirle, Lutz). Martenstein indicates that in sarcoids the virulence of the tbc bacillus is so diminished that it does not produce an allergic effect. In some cases however the syphilitic nature of the disease is undoubtedly proved (Potrie, Bloch, Mzareulov). Darier and Lewandowski also express themselves for the fact that in some cases the nature of sarcoids is unknown and that sarcoids are a syndrome, in the etiology of which nevertheless tbc is most often found, and this especially concerns Bazin's indurated erythema and subcutaneous sarcoids. Some (Diller, Kreibich) consider sarcoids as "an independent infectious granuloma".-The prognosis is mostly favorable-almost complete recovery can occur, but recurrences are possible. Working capacity is more often not disturbed. The treatment consists in the application of arsenic preparations, which give very often good results. Sometimes also acts very well salvarsan. Darier recommends mercury preparations (calomel), and sometimes resorts to treatment with intracutaneous injections of very small doses of tuberculin, combining the latter with salvarsan preparations.

3. Grzhebin.