218 Transactions of the Society. 



repellent to mosquitoes in addition to lice and fleas. Such powder 

 is especially useful in summer and in hot countries, as it has a 

 cooling effect on the skin and often prevents prickly heat. 



As regards ointments, we found the rather interesting and 

 useful fact that plain vaseline has a powerful action on lice, and it 

 is doubtful whether the addition of white precipitate and other 

 chemicals increases its action. In practice, however, it is useful 

 to add a small amount of white precipitate (3 gr. to 1 oz.), as it has 

 a beneficial effect on secondary pyogenic infections, so common in 

 persons infested with lice. 



III. — Eelapsing Fever. 



Eelapsing fever was extremely common in Serbia in 1915, in 

 the spring and summer especially. It was not rare in 1916 among 

 the Serbian troops in Corfu, after the retreat through Albania, and 

 cases have been seen by me, again, in the Balkans this past winter. 

 I would call attention to the comparative frequency of mixed 

 infections which were seen in 1915 — typhus exanthematicus + 

 relapsing fever; malaria + relapsing fever. In Skopolje in 1915 

 it was extremely common to see relapsing fever develop in con- 

 valescents from typhus. The frequent co-existence of the two 

 infections is probably explainable from their being carried by the 

 same insect, the louse ; though personally I am inclined to think 

 that relapsing fever is carried also by bed-bugs. 



As regards the aetiology of the disease, as I hope to demonstrate 

 in a future publication, I believe that in Europe, as in Africa, 

 America, and Asia, it is due to several species of spirochsetes, 

 and not to one only {Spiroclissta recurrentis Obermeyer). As 

 regards clinical symptoms, I would point out how extremely 

 difficult it is to diagnose from purely clinical symptoms, at the 

 onset of the first attack,. relapsing fever from typhus, malaria, and 

 pappataci fever — only the microscope can help us. 



lY. — Pappataci Fever. 



This fever is extremely common in summer all over the 

 Balkanic and Adriatic Zone. The so-called Uskub and Skopolje 

 Fever, epidemics of which occur regularly every year in Skopolje 

 and surrounding Macedonian districts, I found out in 1915 to be 

 also Pappataci Fever. The disease, but for the rash, is very similar 

 to Dengue as I have seen it in the Far East and Ceylon. It 

 begins suddenly with rheumatoid pains all over the body, head- 

 ache, pains in the eyeballs, fever (which seldom goes higher than 

 104°), no rigors. The face is flushed, and has often the appearance 

 of being slightly bloated. Tlie flushing is often so marked and 



