Four Gases of Pyrexia due to Infection with a Bacillus of 



THE B. Cloace Type 

 WITH Notes on thk Vaccine Treatment of Tw(j of these Gases 



BY 



Gaptain li. G. Auchibali), M.B., E.A.M.C., attached E.A. 



Piithologist iuiil Assistant Bacteriologist 



Wellcome Tropical Research Laboratories, Khartoum 



The researches in tropical fevers have of recent years achieved such success, that 

 it has now become possible not only to classify many of these fevers according to the 

 type of pyrexia present, but also to state their etiology. 



Many, however, of what constitute the so-called low fevers, pyrexias of uncertain 

 origin, pseudo-typhoid, etc., require further light to be thrown on them to justify their 

 present nomenclature, and one is inclined to think that, if a systematic series of blood 

 cultures was carried out on all such types of fevers, their etiology would gradually be 

 disclosed. 



It is a connnou experience in these laboratories, more especially in the hot weather, to 

 have a number of blood capsules sent from cases of pyrexia with the request that 

 agglutination tests with the B. typhosus, jjaratyplioid group, and the M. iiieliteusis be 

 carried out. The results of these tests have, for the most part, been negative, as enteric and 

 Malta fever are not common in Khartoum. Examinations of the blood films of these cases 

 eliminate malaria, and the question of a tubercle infection is then considered. Eventually, in 

 the course of ten days or so, recovery occurs, and, as a rule, no definite diagnosis is arrived at. 



It is for such cases of pyrexia that one puts in a plea for the procedure of blood eiood cultu 

 culture, a procedure not to be carried out as a dernier resort after agglutination tests, etc., f°'' early 



■■^ . diagnosis 



have failed, but to be employed in the early stages of the disease. 



During the summer of last year, various types of fevers presented themselves, and 

 amongst the most interesting were three cases, which occurred in the 3rd Egyptian 

 Battalion, and one case which occurred in an Englishman. These four cases were of 

 interest, in that they resembled each other clinically, and in three of them the same 

 micro-organism was isolated by means of blood culture. 



The three cases from the Egyptian battalion were all admitted to the Khartoum 

 Military Hospital within a few days of each other, while the fourth case occurred somewhat 

 later. Through the kindness of Captain A. G. Cummins, E.A.M.C., one was able to receive 

 full notes, together with the temperature charts, of these cases. I am also indebted to that 

 officer for the great assistance rendered in carrying out the blood cultures, etc. For 

 the notes and temperature charts of Case IV., which was admitted to the Khartoum 

 Civil Hospital, I am indebted to Dr. H. C. Squires, of the Sudan Medical Department. 



For convenience, the cases in the Egyptian Battalion will be named Cases I., II. 

 and III., while that occurring in the Englishman will be described as Case IV. 



In Cases I. and IV. a vaccine treatment was employed, and they will be described 

 in fuller detail. 



