ONSET 23 



smears were taken from each case. Thick smears were de- 

 hemoglobinized before staining; both thick and thin smears 

 were fixed with absolute alcohol and stained with Giemsa. 

 Granules of various sorts were seen and bacteria, usually com- 

 ing from water or stain, were frequently found. In no instance 

 were appearances observed which could with any approach to 

 certainty be regarded as rickettsia; nevertheless, appearances 

 were seen in two or three cases of which it could not be said 

 that they were not rickettsia. No cases showed plasmodia of 

 malaria or organisms of relapsing fever. 



9. URINE 



In all cases the urine was concentrated, with albumin in 

 slight to moderate amounts, as in other febrile diseases of like 

 severity. No case showed findings in the urine which could 

 warrant a diagnosis of acute nephritis. 



10. AGGLUTINATION REACTIONS 



Mr. Henry Pinkerton, S.B., of the Commission did agglutina- 

 tion tests for B. typhosus, B. paratyphosus A and B. para- 

 typhosus B with the blood serum of 90 of our cases (see p. 34). 

 B. typhosus was agglutinated in maximum dilutions of from 

 1-200 to 1-1600 in 15 cases; in maximum dilutions of 1-25 to 

 1-100 in 27; 48 gave no agglutination. One of the cases of high 

 agglutination gave a history of previous typhoid; two others, 

 and perhaps more, had probably had immunizing injections. 

 But in most cases of positive agglutinations with the typhoid 

 bacillus no clinical explanation was found, either in the past 

 history or in signs of double infection in the current illness. It 

 is probable that these agglutinations were due to the peculiar 

 propensity of typhus fever to show non-specific agglutinations. 

 The reactions with the paratyphoid bacilli, both A and B, 

 however, were all negative with the exceptions of the two cases 

 believed to have had prophylactic injections. 



Mr. Pinkerton also made agglutination tests with two strains 

 of Bacillus proteus (the Weil-Felix reaction) in 83 cases. His 



