382 APPENDIX 



Recently cell inclusions in polymorphonuclears have been supposed to be diag- 

 nostic; other diseases however seem to give them as measles, diphtheria, etc. 



Small-pox and Vaccinia. Guarnieri and Councilman have implicated epithelial 

 protozoa. 



Spotted Fever of the Rocky Mountains. Supposed to be due to an unknown 

 protozoon transmitted by a tick, D. andersoni. 



Typhus Fever. It has been suggested that the cause may be a protozoon trans- 

 mitted by vermin. 



Recent work by Anderson and Ricketts has shown that the blood of human cases 

 is infective for monkeys. The virus does not seem to pass through a Berkefeld 

 filter and the epidemiology points to the body louse as the transmitting agent. 



Varicella. Entirely unknown. 



Whooping Cough. Influenza-like bacilli have been implicated. Bordet- 

 Gengou bacillus. 



Or TROPICAL CLIMATES. 



Ainhum. A disease characterized by a constricting fibrous ring, especially of 

 little toe, often leading to spontaneous amputation. 



Beriberi. Various microorganisms and food factors suggested. A form of 

 multiple neuritis, occurring chiefly in countries where rice is the staple food, char- 

 acterized by oedema and marked cardiac and respiratory embarrassment. The 

 vagal involvement produces grave symptoms. Rice from which the pericarp has 

 been largely removed, polished rice, implicated. 



Blackwater Fever. Considered as a malarial disease, but thought by some to 

 be possibly caused by a protozoon a Babesia (Piroplasma). A disease usually 

 occurring in malarial patients characterized by rapid febrile onset, early jaundice, 

 asthenia, pain in loins and the pathognomonic haemoglobinuria. 



Dengue. Supposed to be due to a protozoon transmitted by Culex fatigans. 

 A disease characterized by sudden onset, high fever for three or four days, pains 

 in the postorbital regions, back and about joints. A remission occurs on the third 

 to fifth day followed by a secondary rise of temperature and a measles-like eruption. 

 Leukopenia and reduction in the percentage of polymorphonuclears. Virus exists 

 in the blood and is filterable. 



Goundou. Symmetrical bony tumors of nasal processes of superior maxillary 

 bones. 



Pellagra. A disease about which two etiological views exist (i) that it is con- 

 nected with the ingestion of spoiled maize, the other that it is of protozoal nature 

 and transmitted either by Simulium reptans or Stomoxys calcitrans. It is char- 

 acterized by (i) a sprue-like stomatitis and disorders of alimentary canal (2) an 

 erythema usually limited to parts exposed to the sun and characterized by marked 

 symmetry and striking delimitation from the sound skin and (3) various neuro- 

 logical manifestations and a toxic psychosis which may go on to confusional insanity. 

 The disease is characterized by annual recurrences in the spring with improvement 

 in the winter. 



Rat-bite Disease. A disease caused by the bite of rats. Rather common in 

 Japan. Five weeks after bite when wound has healed, high fever sets in, cicatrix 



