946 DISEASES CAUSED BY FILTRABLE VIRUS 



he examined. He never obtained agglutination with the blood of 

 non-typhus cases, using dilutions of 1 :20 in all the tests. Weil 

 and Felix found that almost all their clinically typical typhus cases 

 agglutinated this organism, whereas very few sera of non-typhus 

 patients and no normal sera showed agglutination in dilutions of 

 1 :25. Fairley repored that of thirty-five cases examined during the 

 febrile stage, all agglutinated the organisms in dilutions of 1 :20 

 and 1 :1200 after the fifth day and throughout the second week. 



The test is carried out by growing the organisms on agar, sus- 

 pending them in salt solution and testing with dilutions of 1 :25 and 

 1 :50 of the serum of suspected cases. The agglutination titer in 

 true typhus cases may rise as high as 1 :200 or higher by the end 

 of the second week. Bengston states that in one test made on a 

 typhus case there was complete agglutination of the Weil-Felix 

 organisms in diluton of 1 :400, while cultures of the Rawlings typhoid 

 and of Proteus vulgaris were not agglutinated in dilutions of 1 :50. 



The explanation of this reaction is doubtful. It may be assumed 

 quite definitely that this organism has no etiological relationship 

 to typhus. It is possible that in typhus fever secondary, non-specific 

 agglutinating antibodies for a variety of organisms may be present. 

 We need only call attention to the antibody reactions carried out 

 with the Plotz bacillus and with some of the other organisms for 

 which etiological relationship has been claimed in this connection. 

 Incidentally, the Weil-Felix reaction adds to our scepticism about 

 Plotz 's claims. 



TRENCH FEVER (WOLHYNIAN FEVER) 



In 1919 there appeared among the Armies at the front a disease 

 which did not clinically resemble the ordinary well-known febrile 

 diseases. Cases of this condition were seen among British troops 

 by Graham and Herringham 31 and on the German front in Poland 

 and Wolhynia similar ones were described by His 32 and by W T erner. 33 

 Apparently the disease had been noticed by Gratzer 34 as early as 

 1914. Cases appeared in enormous numbers and because the disease 



31 Graham, Lancet, 2, 1915, 703; Herringham, Lancet, 9, 1916, 429. 



32 His, Berl. klin. Woch., 53, 1916, 738. 



33 Werner, Munch. Med. Woch., 63, 402, 1916. 

 4 Gratzer, Wien. klin. Woch., 29, 295, 1916. 





