517 
with dengue. In typhoid it is the rule to have a more or less constant 
increase in the percentage of the small lymphocytes, while in malaria 
we are all familiar with the fact that there is a large proportion of large 
mononuclears. In dengue we have at different periods the characteristics 
of these two diseases. E 
The blood has invariably shown a leucopenia, the counts varying from 
1,450 to 5,280 per cubic millimeter. This fact, together with the 
differential count, would easily differentiate scarlet fever and measles. 
From the beginning it was my aim in studying the blood of dengue 
to discover the bodies described by Graham of Beirut. 
It will be remembered that this author claimed to have discovered a 
non-pigmented protozoon in the blood of patients suffering from dengue. 
He stated that it was constantly changing its position in the blood cell 
and that it increased from day to day so that by the fifth or sixth one 
it would be more than one-half the size of the red cell, and diagram- 
matically he represented it as at times projecting from the cell like a 
pseudopod. He stated that he was unable to stain these bodies. He also 
claimed that he found oval and spherical spores in the stomach and’ 
salivary glands of culex, these spores appearing forty-eight hours after 
the mosquito became infected. I have repeatedly and for extended 
periods searched blood specimens without finding anything which might 
be termed peculiar. As previously stated, I was struck with the remark- 
able vacuolations observed in fresh specimens. 
My method of work was from time to time to examine fresh specimens, 
carefully ringed with vaseline, until crenation was so general as to be 
confusing. Any peculiarity of the red or white cells was noted, and 
specimens of the blood which were stained in three ways were carefully 
examined to verify such supposed findings. Films were stained with 
Wright’s blood stain, hematoxylin, and eosin, and with thionin. In no: 
a single instance could I find anything which would suggest a protozoén. 
Occasionally, I also employed prolonged staining with Wright’s stain 
according to the method suggested by Castellani as a substitute for 
Giemsa’s stain as used for Spirochaeta pallida. 
While I did not have an opportunity to verify Graham’s findings in 
regard to the mosquito, yet there are certain observations which would 
tend to strengthen his claim that the disease is transmitted by a species 
of culex. very case of dengue sent to the Naval Hospital at Canacao 
has been treated in the wards, yet not once has there been an instance of 
infection among the large number of non-immunes who were present 
in the hospital. When the hospital was located at Cavite, it was com- 
monly noted that practically every case admitted became infected with 
dengue while under treatment for the original complaint. During the 
present small epidemic in Cavite it has been observed that newcomers, 
sleeping’ in Cavite, were frequently infected. Since the admission of 
our first case in October, 1905, there has been a noticeable freedom from 
the mosquito pest, so much so that recently, even after carefully searching 
