442 YELLOW FEVER 



Bahr is inclined to believe that Monilia albicans (Oidium albicans} is the cause 

 as he found these saccharomycetes in the deep layers of the tongue, in the mucoid 

 coating of the intestines and in the deposit in the oesophagus. He thinks it the 

 ordinary thrush species which may take on greater virulence in the tropics. Ashford 

 states that he has found a species of Monilia, different from that of thrush, almost 

 constantly in tongue scrapings and stools of sprue cases and he regards this species 

 as the cause of sprue. He states that this organism is common in Porto Rico bread 

 and thinks it possible that the disease is transmitted in this way. Wood has re- 

 cently expressed the view that sprue is not infrequently mistaken for pellagra in 

 the southern United States. 



Tsutsugamushi. A disease of Japan somewhat resembling typhus 

 fever. Supposed to be due to a protozoon transmitted by the Kedani 

 mite. 



Verruga Peruana. A disease of Peru formerly considered as a later 

 stage of Oroya fever. 



The eruption of verruga somewhat resembles that of yaws and it was at one time 

 suggested that verruga was simply yaws as influenced by high altitude. Strong 

 and his colleagues found that they could infect rabbits intratesticularly and that 

 lesions resembling those of man could be produced in dogs and monkeys by cuta- 

 neous and subcutaneous inoculations. The virus has been transmitted from monkey 

 to monkey. The Wassermann reaction was negative. In extracts from the granu- 

 lomatous lesions they found a very active haemolysin. It will be remembered that 

 animals are not susceptible to Oroya fever blood inoculations. 



From the fact that it is possible to inoculate a person by rubbing verruga material 

 on a scarified surface it would seem that the infection might be transmitted by 

 insects. 



Yellow Fever. Due to a filterable virus transmitted by the Stego- 

 myia calopus. A disease characterized by sudden onset, rachialgia, 

 albuminuria, jaundice and often haemorrhages about the third day. 

 Pulse becomes slow even with rising temperature. Black vomit often 



precedes fatal termination. Virus exists in the blood and is filterable. 

 P 



The virus is present in the blood of the peripheral circulation only during the 

 first three days of the disease. A female Stegomyia sucking the human blood 

 during the first three days from onset of fever may become infected but cannot 

 transmit yellow fever to a second person until after the expiration of at least twelve 

 days, during which time some development of the virus, of the character of which 

 we are in ignorance, goes on in the mosquito. 



Seidelin has stated that he has found a protozoon, Paraplasma 

 flavigenum, in the blood of yellow-fever patients. Authorities generally 

 deny the existence of this parasite. 



