RELAPSING FEVER 147 



tent fever, or the specific continued fevers which pre- 

 vail there so largely, was not clearly made out by 

 the earlier observers. During the last thirty years, 

 however, numerous outbreaks of this disease in vari- 

 ous parts of India have been recorded, and Carter 

 has demonstrated that the disease, as it occurs in that 

 country, is identical, as regards its clinical history, 

 with relapsing fever, as described by recent European 

 authorities ; and, also, that it is characterised by the 

 constant presence of the spirillum discovered by 

 Obermeier in blood drawn during a febrile paroxysm. 

 Relapsing fever has several times been imported to the 

 United States, but its prevalence has been limited 

 to restricted areas in our largest seaport cities. 

 In 1844 fifteen cases were received into the Phila- 

 delphia Hospital from an emigrant ship sailing from 

 Liverpool ; in 1848 a few cases arrived in New York ; 

 and in 1850-51 Dr. Austin Flint saw a number of 

 cases, among recently arrived Irish emigrants received 

 into the Buffalo City Hospital. But no epidemic re- 

 sulted from these importations, and it was not until 

 some years later (1869-70) that the disease became 

 epidemic in certain sections of the cities of New York 

 and Philadelphia. Parry, who made a careful investi- 

 gation with reference to the origin of the first cases 

 in Philadelphia, was unable to trace them to importa- 

 tion ; but this can scarcely be questioned, in view of 



