70 BBVIEW — TROPICAL MEDICINE, ETC. 



Fevers — An interesting account of Miliary Fever, or " Sweating Sickness," is given in the 



conlinued Lancet of November 17th, 1906, while Scholz>* has recently reported an epidemic of this 



curious disease, the infection of which Chantemesse suggests may be carried by the fleas of 



field mice. He noticed that the districts concerned had been overrun by these rodents and 



that many of the patients exhibited flea bites. 



McCowen- has described very fully a Bilious Typhus Eelapsing Fever, but as this really 

 seems to bo a special and definite form of true relapsing fever it will be considered under 

 that heading. 



Eow^ has a paper on serum reactions in obscure, irregular, continued fevers in India 

 which led him to believe that both the Bacillus enterHidis of Gaertner and the Bacillus culi 

 communis, especially the latter, stand in causal relationship to some of these forms of illness. 

 Indeed, in some measure he anticipates the more recent work of Rogers and Castellani. 



The same point was urged as regards Simple Continued Fever even earlier by 

 Caldwell,* who quotes the still earlier work of Busch.^* At the same time, it must 

 be remembered that in 1902 the agglutination reaction in all its phases was not so fully 

 worked out as is now the case, and it seems desirable that definite evidence should be 

 obtained as to the role of B. coli in these obscure but common cases. 



Brief reference may be made to De Korte's paper'* on Amaas or Kaffir Milk-pox, which 

 seems to be small-pox mitigated by some undetermined factor or factors. It is not varioloid 

 varicella, and is to be distinguished from what is known as Infectious Disease in Lascars. 

 It is quite possible that amongst coloured races true modified small-pox occurs, and 

 Colonel Hunter has told me that he has frequently wondered how often some of the 

 outbreaks of so-called varicella in the Sudan are really mild and modified variola. 



The point is one worthy of attention, albeit variola is steadily diminishing owing to 

 general and efficient vaccination. 



Filariasis. Low" has dealt with the unequal distribution of filariasis in the 

 tropics. His researches were carried out in the West Indies, the distribution of F. nocturna, 

 F. demarquaii and F. perstans being noted. He found that 



where there was much clinical filarial disease, elephantiasis, etc., then the percentage of ordinary healthy 

 people with embryos in their blood was high ; where there was little disease, then the percentage was low. 

 As regards F. nocturnu, he found that its distribution in the various islands was very peculiar and interesting, 

 and records his belief that there was something over and above the mere presence or absence of C. fntigans to 

 account for the peculiarities he encountered. Much the same as regards distribution was true of F. demarquaii 

 and F. 2>''rstins, even though, as he points out with regard to these parasites, we are not on such certain ground, as 

 their proper intermediate hosts are unknown, unless the tick, Ornithodoros moiibata, as Wellman believes, acts for 

 the latter. Hence their irregular distribution may depend on the presence or absence of the intermediary. In a 

 discussion on this paper, Sambon stated that he believed that several worms had been confounded under the name 

 Filaria banerofli. He suggested that hypcr-parasitism might explain the absence of filarite from certain regions. 

 Lciper confirmed Low's statement as to the prevalence of F.pcrstans (i.e. the blunt-tailed embrj'os) in the blood 

 of African natives in Uganda and E. Africa, and to the absence of the sharp-tailed embryos {F. diurna and 

 F. nocturna). He pointed out, however, that though sharp-tailed embryos did not occur in Africa in man they were 

 present in monkeys, and in these resembled very closely the embryos of F. noclurna found in the W. Indies. He 

 also mentioned that distribution could not be determined on larval forms alone. 



Sandwith stated that filariasis was not an extremely common disease in Lower Egypt, and that neither he nor 

 anyone else in a.ll probability could speak as to its incidence amongst Nubians. He also referred to Hayward's 

 observations, who examined 400 patients in the hospital at Port Said and found that 15 per cent, of them were 

 infected. Manson "asked why it should be that in countries where C. fatiijitns was eiiually prevalent the disease 

 it produced was very common in one, and in another it was very rare ? He believed that if a satisfai'tory answer 

 could be found, the means to counteract the pathogenic influence of the filaria would be also forthcoming. He further 

 discussed the question of repeated re-infections and the remarkable fact that the propagation of the filaria was 

 restricted in some way or other. He had obtained no evidence of hyper-parasitism and thought there must be 

 some other explanation. He also discussed the relation of filariasis to elephantiasis and the fact mentioned by 



' Soholz. Zeit. f. Klin. Med. Vol. LIX., Nob. 5, 6. 



2 McCowen, W. T. (October, 1906), " Bilious Relapsing Fever." Indian Medical Gazelle, p. 387, Vol. XLI. 



'■^ Bow, R. (August, 1905), "Obscure, Irregular, Continued Fevers of the Typhoid Group, .and their Probable 

 Relation with different species of Bacilli of the Typliu-Coli Race." Indian Medical Onzclte, p. 292, Vol. XL. 



■• Caldwell, R. (February, 1904), " Simple Continued Fever : Its Cause and Prevention." Jnuriial of Slate 

 Medicine, p. 103, Vol. XII. 



^ Busch, P. C. (May 31st, 1902). New York Medical .Tnurnal. 



De Korte, W. E. (May 7th, 1904), " Amaas or Kaffir Milk-pox." Lancet, p. 1273, Vol. I. 



■" Low, Q. C. (February 15th, 1908), " The Unequal Distribution of Filariasis in the Tropics." Journal of 

 Tropical Medicine and Hygiene, p. 59, Vol. XI. 



• Article not consulted in the original. 



