74 



THE SPIBOCH.ETE OF EGYPTIAN RELAPSING FEVEB 



Comparison of 

 the Egyptian 

 Spiro<h:etosis 

 with other 

 varieties 



Probable 

 identity of 

 Egyptian 

 Spirochaetosis 

 with that due 

 to S/i. tirrhrra 



while the spirochsete was inoculable from m;in to tlio monkey (Macacus siveimi, 

 M. ri/)iomologus, M. inuiif, Gynocephahts sjihiti.v), it could not he transferred from 

 monkey to monkey. 



Now this appears also to be true of the Egyptian spirochaBte, nlthoiif^h my single 

 inoculation from monkey to monkey (Oercopithecus sahaeus), was, most unfortunately, not 

 made at the time most favourable to ensure success. 



Sergent and Foley found that rats and mice could be inoculated, but ran a very mild 

 course and recovered. This I found true of gerbils. They also observed that it was 

 well-nigh impossible to obtain successive passages in rats and mice. These sub-inoculations 

 only succeeded in the case of some newly-born mice. I have no parallel observation to 

 record, and had no ordinary laboratory white rats or mice available. I obtained some 

 white rats with all speed from Cairo, but they arrived too late. 



Considering the paucity of my experiments and observations, it is jjerhaps scarcely 

 worth while to enter at great length into a full comparison between this Egyptian 

 spirochmtosis, the well-known American, European, African and Indian varieties, and the 

 new Algerian type, but, taking a leaf out of Mackie's' and Clioksy's" books, J have followed 

 the excellent plan of comparative tables adopted by them, and, so far as is possible, have 

 compared all the different species of spirochetes and the fevers they cause. I have added 

 somewhat to Choksy's lists and altered them as seemed desirable, with the results shown in 

 the tables. The entries regarding the symptomatology of the Egyptian fever are, of course, 

 derived from Captain Bousfield's paper, and from such recollection of the cases as I possess. 



It is scarcely necessary to point out that such tables as those given must be accepted 

 with some reservation. A great deal, naturally, depends on the personal equation, both as 

 regards the observer and the patient, while environment may play a part. Again, it is 

 scarcely scientific or correct to compare an epidemic of eight cases with one of forty-two, or 

 to compare the symptoms seen in both with those observed in a very large number of cases 

 of the other forms of spirochiEtosis. Still, bearing these sources of fallacy in mind, the 

 comparisons may be of some service. 



This Egyptian spirochaetosis is certainly not tlic true African form due to Sp. duttimi ; 

 the American variety, for several reasons, can be excluded, and the animal reactions would 

 appear to put the European form out of court. Of the well-known varieties there remains 

 the Indian type, due to Sp. carferi. It is strange that Sergent and Foley do not compare 

 their spirochete with the Indian species, or the Algerian illness with that prevalent in 

 India. This is the more remarkable as there is evidence in both diseases to show that lice 

 act as carriers of the virus, a fact mentioned by the French observers. Perhaps, however, 

 they did not trouble to do so owing to the fact that the results of animal inoculations differ 

 in the two cases. Sp. carteri can be transmitted from monkey to monkey and from mouse 

 to mouse. Moreover, the blood of a monkey in the apyrexial stage remains infective, 

 so that Mackie' concludes that the spirillum remains in the circulating blood in an 

 unrecognised and ultra-microscopic form. 



Taking everything into consideration, I believe that Sergent and Foley are justified in 

 regarding the fever in South Oran as a sijecial form due to a specific spirochaste, and, from 

 such facts as one has been able to gather or establish regarding the Egyptian illness, 

 I am inclined to think it is the same disease, due, therefore, to Sp. berhera, and conveyed 

 by lice. This, also, despite Strong's" note to the effect that he has seen in Egypt 

 infectious due both to Sp. ri-curreiitis and Sp. duftoni.* The view advanced is in favour of 

 Dreyer's supposition, but it is evident that much more work will have to be accomplished 

 before we can be absolutely certain that there is a distinct North African spirochetosis of 



