J'ERRUGA PERU J 'I AN A 363 



VERRUGA PERUVIANA. 

 DEFINITION. 



It is a clironic, endemic, non-contagious disease of unk-no\vn origin, 

 resembling raws. It is characterized by irregular fever, associated 

 with rheumatoid pains, anaemia and granulomata of the skin, mucous 

 membrane and viscera. 



HISTORY. 



It was in South America before the Spaniards. It was recorded 

 there in 1543. 



In 1885, D. A. Carrion, a student of medicine at Lima, desiring to 

 know if a fever then present was related to verruga, vaccinated botli 

 arms with the blood from a verruga tumour. In twenty-one days 

 symptoms set in and he died of the fever five weeks later. Conse- 

 quenth- it is sometimes known as Carrion's fever. 



DISTRIBUTION. 



It is confined to certain provinces in South America. Peru is the 

 most endemic area. It is prevalent on the western slopes of the Andes 

 and Ecuador, Bolivia, and the northern parts of Chili. 



It is found in narrow valleys, along tributaries of rivers and small 

 streams. The disease only occurs in summer when rivers are in flood 

 and insects abound. Drinking-water is blamed by some of the people. 



AETIOLOGY. 



The causative organism is unknown. Perhaps it is some blood- 

 sucking animal that carries it such as the arachnoid. 



As a rule one attack confers immunity. 



Strangers visiting an endemic centre are very prone to it. 



Xewly-born infants may acquire the disease. 



In some respects it resembles yaws, but unlike that disease, it 

 attacks both domestic animals and man. 



PATHOLOGY. 



Some doubt the identification of Carrion's fever with nodular fever. 



The two diseases have not yet been proved tO' be identical. 



The disease is said to commonly occur among animals, &c., as 

 horses, mules, asses, dogs, and also fow^ls. 



Post mortem, there is marked pallor of the bod\', oedema and 

 dropsy, hypostasis of the lungs, enlargement of the liver and spleen, 

 hyperasmia of the bone marrow. Then there are the verrugas of the 

 skin and other parts of the body. 



HISTOPATHOLOGY. A kind of neoplasm begins about a capillary 



vessel, the areolar tissue reacting through some perivascular irritant. 



The connective tissue fibres swell, embracing embryonic connective 



