257 



severe albuminuric yellow fever, slight appearance of black vomit, intense 

 uraemic delirium, parotitis during convalescence, and prolonged mental 

 derangement ; the third has so far escaped the infection. No death. All 

 three had arrived in December 1893. 



The mortality among the non-inoculated of both communities has been 

 therefore 1.5, equivalent to 20 per cent. 



Among the seventeen inoculated Jesuits, a series of eight cases occur- 

 red between the 16th of August and the 2d of November, consisting of five 

 "acclimation fevers", one mild albuminuric, one regular albuminuric yel- 

 low fever, and one fatal albuminuric without black vomit. 



Among the ten inoculated Carmelites, a series of seven cases occurred 

 from the 16th of August to the 27th of November. Five were '¡acclimation 

 fevers ' ', one was a severe albuminuric case, and the seventh a fatal melano- 

 albuminuric. 



The mortality among the twenty-seven inoculated of both communities — 

 2.27, or 9 per cent. 



The mortality among those who were attacked with the disease was 

 1.3 — 33 per cent for the non-inoculated and 2.15 — 13 per cent for the 

 inoculated. 



By a singular coincidence it happened that both the fatal cases among 

 the inoculated Carmelites and the fatal case among the non-inoculated Je- 

 suits only came nuder treatment when the disease had already advanced 

 beyond any chance of control. 



The fatal case among the inoculated Jesuits had been inoculated on 

 his arrival six years ago, and had never experienced fevers of any kind until 

 his fatal yellow fever. It might therefore be inferred that the protection 

 conferred by the mosquito inoculation may be, under certain cincumstan- 

 ces (as happens with cow-pox vaccinations), totally or partially lost after 

 five or six years. This is confirmed by the facts that the Jesuit who suffered 

 an attack of mild albuminuric fever had arrived in Havana and been ino- 

 culated at the same time as the former, and he likewise never experienced 

 any attack of fever until the present year. A third Jesuit, who came and 

 was inoculated at the same time, but returned to Spain after four years' 

 residence in Havana, never experienced any fever at all. 



Among the Carmelites, on the other hand, of the seven inoculated 

 who were attacked, all but one, who had acclimation fever, had arrived and 

 been inoculated within the last twelve months. The fatal case of this group 

 had presented some peculiarities worthy of notice. A fortnight before his 

 2nd attack of yellow fever he was taken with haemoptysis occasioned by 

 heart disease (mitral insufficiency), of which he had been suffering before 

 in Spain, It is probable that this circumstance contributed in the early 

 appearance- of albuminuria and suppression of urine which characterised 

 his illness. 



