﻿ETIOLOGY OF DENGUE FEVER. 125 



Experiment No. 9. 



Case 9, Chart 9. — E. J. D., private Hospital Corps, United States Army. On 

 August 21, 1906, 10 cubic centimeters of blood was drawn from the median basilic 

 vein of Case 2, an experimental case of dengue which has been described (see 

 Case 2, Chart 2 ) . The blood was taken on the third day of the disease, the 

 symptoms of the patient at the time consisting of fever, headache, severe pain 

 in the muscles of the shoulders, in the wrists and knees, while there was present 

 a typical dengue eruption. 



The blood was rapidly defibrinated, diluted with an equal amount of normal 

 salt solution, and filtered through a Lilliput filter, controlled as described. The 

 filtration of a sufficient quantity for use was completed in about three-quarters 

 of an hour. Of the filtrate, 50 minims, containing 20 minims of the filtered 

 blood, was inoculated intravenously into Case 9 at 4.20 p. m., August 21. The 

 patient at the time of inoculation had been in the hospital under observation 

 for several weeks, and as no cases of dengue had occurred in the hospital, he had 

 not been exposed to the disease. No symptoms of importance developed until 

 August 25, the period of incubation being three days and eleven hours. Previous 

 to the decided onset of the disease there had been slight fever and some pain in 

 the back, symptoms which were probably due to a gonorrhoea from which he had 

 suffered for some time. The following is the clinical record of this case: 



August 21 : Inoculated intravenously at 4.20 p. m. with 25 minims of filtered 

 dengue blood from Case 2. 



August 22 and 23: Feeling well. 



August 24: Slight muscular pains. 



August 25, 9 a. m. : Patient complains of pain in muscles of neck, shoulders 

 and knees. Has some headache. Bowels constipated. Tongue moist and clean. 



August 25, 4 p.m.: The symptoms have increased in severity. The headache 

 is frontal and intense; there is severe pain located behind the eyeballs, which 

 are painful on pressure. There is general muscular pain, especially in the muscles 

 of the jaw, lumbar region, and in the calves of the leg. Patient states that his 

 bones ache and that he is unable to rest comfortably in any position. He also 

 complains of severe pain in the articulations. An eruption is present, covering 

 the chest, abdomen and thighs, and is especially marked over the forearms and 

 around the wrists; it is dull red in color, consisting of minute elevations sur- 

 rounded by a vivid flush, which makes the rash appear confluent in character. 



August 26 : Patient passed a very restless night, suffering from insomnia and 

 severe pain in the back, chest, legs, head, and eyes. This morning still has severe 

 pain in these regions. There has been no vomiting and the bowels are constipated. 

 Tongue is moist, with a slight white coating. The eruption covers the entire body 

 and is more marked than yesterday. There is complete loss of appetite and the 

 patient is very restless. 



August 27: Feels much more comfortable this morning. The steady ache in 

 the muscles has disappeared but he still suffers from lancinating pains in the 

 head, back, and legs. The eruption has almost disappeared. 



August 28: Passed another restless night and suffered a great deal from pain 

 in the muscles. This morning he complains of severe headache and pain in the 

 loins and legs. The eruption has faded from the trunk. Has no appetite. 



August 29: Feels better this morning. Still has headache and pain in the 

 eyes, but the general muscular pain has disappeared. 



August 30: Still complains of pain in the head and eyes but slept well last 

 night. 



