398 TIMOTHY RICHARDS LEWIS. 



times in the same individual, as has been shown to be the case 

 in the preceding pages with regard to the bacilli in the blood. 



It may be useful to say a few words, in passing, regarding 

 the fever which was so prevalent in Bombay during a great 

 part of 1877, as some misapprehension appears to exist as to 

 its exact character. What is described as recurrent fever, and 

 sometimes as bihous typhus or bilious remittent fever, and 

 recurrent typhus^ in Germany, is frequently assumed in England 

 to be the same as the " relapsing-famine fever," which was 

 witnessed some years ago in Ireland and elsewhere. Whether 

 in reality the latter fever was or was not the direct offspring of 

 want is not a matter calling for comment here, but what is very 

 definitely known is that outbreaks of recurrent fever in various 

 parts of Eussia and Germany, and which were Tound to be 

 associated with spirilla in the blood, have occurred in districts 

 wholly unassociated with want of any kind. In some cases, 

 indeed, the outbreaks occurred in districts and during periods 

 in which the labouring classes were exceptionally well off. This 

 is a point concerning which no doubt whatever can exist. With 

 regard to the supposed connection of the fever in Bombay with 

 the famine which prevailed in certain parts of the country, I 

 can only state that, so far as I could gather as the result of 

 personal observation and careful inquiry, no sufficient grounds 

 existed to warrant any such supposition ; and Surgeon-General 

 Hunter, after a most careful analysis of the official records, 

 and writing from personal acquaintance with the disease, thus 

 sums up his report on this particular point : " Any distinct 

 causal connection, therefore, between the famine and the fever 

 must be abandoned."' 



It thus follows that the term "relapsing-famine fever" is not 

 applicable to the affection hitherto associated with spirilla in the 

 bloodj whether in Germany, Russia, or Bombay. 



H. — The probahilities in favour of the Bacilli and Spirilla of the 

 Blood being Ein-phenomena. 



There is one circumstance in connection with the microscopic 

 appearance which these organisms sometimes present which 

 deserves special mention, as it may serve as an explanation of 

 their sudden disappearance from the blood ; and that is that they 

 may present a well-marked beaded or rosary- chain appearance 

 (fig. 18). This feature I was able to observe on one occasion 

 only. The spirilla of the ordinary character were plentiful in 

 this person's blood on the evening previous to the day on which 

 this observation was made, but when examined on the following 



1 ' Indian Medical Gazette, '.October 1st, 1877. 



