420 PATHOGENIC MICROCOCCI 



hours ; some hours later the casein is precipitated, fine gas bubbles are seen 

 in the lower part of the fluid and a foam upon the surface; the reaction is 

 acid and the casein is not peptonized. The power of producing acid and gas 

 is diminished or lost after a few successive cultures have been made. 



Streptococcus mastitis sporadic^ (Guillebeau) is said by Adametz to be 

 distinguished from the streptococcus above described (No. 44A) by being 

 smaller 0.5 // in diameter and by the fact that the cultures do not lose the 

 power of producing fermentation in milk. 



MICROCOCCUS MELITENSIS. 



Surgeon-Major Bruce, of the British army, in 1887 demonstrated 

 the etiological relation of a micrococcus, now known as Micrococcus 

 melitensis, to the infectious disease known as Malta fever (syn- 

 onyms: Mediterranean fever; Neapolitan fever; Rock fever of Gib- 

 raltar, etc.). Subsequent researches show that this fever is not re- 

 stricted to the Mediterranean region, and it will probably be found 

 to have an extensive area of prevalence on both continents. Cases 

 have been recognized in America and by medical officers of the army 

 stationed in the Philippine Islands. Curry (Captain and Assistant 

 Surgeon United States Volunteers), in a recent report to the Surgeon- 

 General of the army, says : 



"I had the honor to report to the Surgeon-General of the Army on Jan- 

 uary 2d, 1900, four cases of Mediterranean or Malta fever, which came under 

 my observation, while on duty as pathologist to the 1st Reserve Hospital in 

 Manila, P. I., cases occurring among our troops and originating on the 

 Island of Luzon. 



"Later, in a report on the ' Diseases of the Philippine Islands,' I reported 

 twelve additional cases. In all these cases a positive serum reaction with 

 the Micrococcus melitensis was obtained, and the clinical history of the cases 

 corresponds with the descriptions of Malta fever as given by the English 

 army surgeons Bruce, Hughes, Wright, Semple, and others, and that de- 

 scribed by Manson. Included in these sixteen cases is one autopsy. 



"In my report on the ' Diseases of the Philippine Islands,' under the head- 

 ing of 'Fevers of the Philippines,' I expressed the belief that 'Malta fever 

 is not an uncommon disease in the Philippine Islands,' and that it appeared 

 that 'Malta fever is by no means as limited geographically as has been 

 thought heretofore.' 



"Our experience here in the Army and Navy General Hospital, Hot 

 Springs, Ark. , has convinced me that Malta fever is widespread in tropical 

 and sub-tropical regions. We are but having a repetition of the experience 

 of the English army surgeons at the Royal Victoria Hospital, Netley. 



"Among the soldiers and sailors, here in our wards, who have been 

 returned from tropical stations, we have found already four to have Malta 

 fever. These four cases came from widely separated stations. Two cases 

 are in soldiers, one from the Philippines, and one from Cuba, and two are 

 among sailors of the United States navy who were recently returned from 

 South Atlantic stations. 



"All four cases entered this hospital with a diagnosis of rheumatism." 



Morphology. Micrococci, about 0.5 i*. in diameter, usually soli- 

 tary or in pairs ; occasionally short chains are seen in cultures. In 



