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SCIENCE. 



[N. S. Vol. XXIII. No. 585, 



the giving of quinine, and if the patient 

 recovers rapidly, show that it is simple 

 uncomplicated malaria. If not, the test 

 of Widal for typhoid and the Faget law 

 for yellow fever until we find better 

 means. The yellow fever parasite or 

 materies morbi must be a parasite, but 

 extremely small, and will be found in the 

 fibrin or serum of the blood, or as a captive 

 in the white blood corpuscles, as the red 

 ones do not appear to suffer in numbers 

 from yellow fever infection, but greatly so 

 in all forms of malarial infection. So 

 the diminution of red blood cells is a diag- 

 nostic factor and a very important one in 

 malarial infection, and its absence in yellow 

 fever helps us to separate the two diseases. 

 The presence of free pigment in the blood 

 is also diagnostic of malarial fever, and 

 was greatly relied upon by my honored and 

 respected preceptor, Professor Joseph 

 Jones, M.D., of the medical department of 

 the University of Louisiana — now medical 

 department of the Tulane University of 

 Louisiana. I am in hopes that the organ- 

 ism recently found by my friends of the 

 Charity Hospital and Emergency Hospital, 

 of which very little has been written, will 

 prove to be the cause. This organism is 

 still sich jtidice, and I would prefer that 

 they describe it, as to them is due the 

 honor of discovery. I hope at last that 

 the long-sought-for yellow-fever, organism 

 has been found. We must wait, however, 

 for more proof— the greatest of honors 

 to the man or men who find it, as it has 

 long been soiight. The malarial patient 

 is more quiet, not as alert as the yellow- 

 fever one. The eyes are not watery in 

 malarial patients, though they may be red. 

 The yellow-fever eye is pink rather than 

 red and watery— 'like a person who has 

 been exposed to irritating smoke.' The 

 malarial eye is not so bright. The j^ellow- 

 fever eye actually shines in the first twenty- 

 four or forty-eight hours, then may get 



dull, I think Paget's law is quite char- 

 acteristic of yellow fever, but is not cer- 

 tain by any means, as charts of Eestivo- 

 autumnal fever do show the same want of 

 correlation. A positive diagnosis can hard- 

 ly be made of yellow fever to differentiate 

 it from malarial fever, unless the malarial 

 parasite is found ; and Torti 's test with qui- 

 nine is positive, when we should conclude 

 that the patient had malarial fever and not 

 yellow fever. Still he might get well in 

 spite of the quinine or other treatment, even 

 if he had yellow fever, so it is best to treat 

 sanitarily all cases of fever by screening, 

 at least with a bar to protect them and 

 others from mosquitoes, even if it is ma- 

 larial. Bile, albumin and casts in the 

 urine, so long thought characteristic of 

 yellow fever, are often found in asstivo- 

 autumnal fever. A point which was 

 brought most forcibly forward by an old 

 physician of this city was this : He said in 

 years gone by they did not question the 

 diagnosis of yellow fever, but when an 

 epidemic of fever would break out, they 

 would ask one another : Does quinine break 

 the fever this year? I think that is quite 

 significant as to the close resemblance of 

 the two fevers when it comes to clinical evi- 

 dence alone, and with the means at hand 

 of the older physicians — no microscopical 

 knowledge, no record of temperature. The 

 only guides for them were those gained by 

 inspection and taxis. The pulse, as we 

 know, gives some help, but little, however, 

 when these two diseases are to be diagnosti- 

 cated one from the other. We have made 

 but little advance, however, in our means 

 of positive diagnosis. It is more positive 

 as to malaria, and when the Eestivo- 

 autumnal parasite is found the cases are 

 ninety-nine in one hundred malarial, and 

 quinine will cure them. I could write 

 pages of symptoms, such as peculiar facial 

 expression of yellow-fever patients; the 



