4O ENTOMOLOGICAL NEWS [Jan., '14 



Human Case of Verruga directly traceable to Phlebotomus 



verrucarum (Dipt.). 



Mr. George E. Nicholson, who has been my assistant in the verruga 

 work since the last of July, and who has rendered particularly efficient 

 service in the investigation at all times, notwithstanding numerous 

 difficulties to be continually overcome, has most unfortunately de- 

 veloped unmistakable symptoms of the disease. A brief outline of 

 the case is as follows : 



On the I7th of September, accompanied by both Mr. Nicholson and 

 Mr. Rust, I went to Verrugas Canyon to secure material of the Phle- 

 botomus for inoculation of laboratory animals. Both Mr. Nicholson 

 and myself have passed numerous nights there on the same work, and 

 Mr. Rust has been there twice. As usual we applied the ointment rec- 

 ommended by Newstead and were not molested by the Phlebotomus 

 up to the time of retiring at about midnight. We all used tight nets 

 for sleeping, through which the Phlebotomus could not pass. During 

 the night, however, while asleep, Mr. Nicholson evidently put his hands 

 above his head so that they came in contact with the net, for in the 

 morning we counted fifty-five unmistakable Phlebotomus bites on the 

 backs of his hands and wrists. These bites are small, irregular in out- 

 line, red, and not raised, as Mr. Rust and I know from a half dozen 

 that we received on July gth while awake and before we had begun 

 to use the ointment. We also know that during all our night collect- 

 ing at Verrugas Canyon from July to September, no other biting in- 

 sect except the Phlebotomus appeared, not even a single culicid, and 

 on one occasion I sat up the entire night. 



Daily examination of Mr. Nicholson's blood revealed nothing ab- 

 normal until October i, when I found what I considered to be the 

 verruga x-bodies in the red cells, but Dr. A. L. Barton, the best known 

 authority on verruga, pronounced them not so. This was due to the 

 smear having been somewhat overstained as compared with Dr. Bar- 

 ton's customary practice in staining. These x-bodies continued in 

 very small number without clinical symptoms of note, other than a 

 headache or slight feverishness at times, until October 25th, when a 

 decided rise of temperature occurred and the x-bodies were found to 

 be much increased in number. Dr. Barton now recognizes these to be 

 the verruga x-bodies, and Mr. Nicholson has entered the Guadalupe 

 Hospital in Callao under Dr. Barton's immediate care. During the 

 past week his temperature has been lower than at first, and the case 

 promises to be of the benign type rather than the malignant. No erup- 

 tion has appeared as yet. Salvarsan was administered intravenously 

 to-day, for the purpose of determining whether it will prove a spe- 

 cific against the disease. CHARLES H. T. TOWNSEND. 

 Chosica, Peru, November loth, 1913. 



