446 MALTA FEVER 



places removed from the main lines of commerce he still found 

 them, though in smaller number. It has also been demonstrated 

 that in some places the ticks are found to be infected with the 

 spirilla although the inhabitants do not suffer from tick fever, a 

 circumstance which is probably due to an acquired immunity 

 against the disease. 



Although our knowledge regarding the relationships of these 

 to other spirilla is far from complete, certain differences between 

 the organisms of European relapsing fever and of African tick 

 fever have been established. Zettnow, for example, has found 

 that the organism of tick fever possesses numerous lateral 

 flagella, whereas, as already stated, the sp. Obermeieri has a 

 single terminal flagellum. This observation, however, has not 

 yet been confirmed. Differences are also brought out by animal 

 inoculation. In addition to the more severe illness produced by 

 the spirillum of tick fever in monkeys, it has been found by 

 Breinl and Kinghorn that a considerable number of animals 

 are susceptible to the African spirillum, including rabbits and 

 guinea-pigs, which appear to be refractory to the organism of 

 relapsing fever. Breinl also compared the immunity conferred 

 by the sp. Obermeieri and by the tick fever spirillum, and found 

 that each conferred a relative active immunity against itself, but 

 not against the other. It is thus highly probable that they 

 represent two distinct species. Spirillar fever has also been 

 found in India, but its relations to the European and African 

 fevers have not yet been fully worked out. 



MALTA FEVER. 



Synonyms Mediterranean Fever : Rock Fever of Gibraltar : 

 Neapolitan Fever, etc. 



This disease is of common occurrence along the shores of the 

 Mediterranean and in its islands. Since its bacteriology has 

 been worked out, it has been found to occur also in India, China, 

 and in some parts of North and South America, its distribution 

 being much wider than was formerly supposed. Although from 

 its symptomatology and pathological anatomy it had been re- 

 cognised as a distinct affection, and was known under various 

 names, its precise etiology was unknown till the publication 

 of the researches of Colonel Bruce in 1887. From the spleen 

 of patients dead of the disease he cultivated a characteristic 

 organism, now known as the micrococcus melitensis, and by 



