﻿126 ASHBURN AND CRAIG. 



August 31 : Patient states that he feels very well this morning. Has no pain 

 and appetite is returning. There is present a very profuse dengue eruption 

 covering the entire body, especially marked upon the arms, legs, hands and feet. 



September 1: Feels well. The eruption is less distinct although it still 

 covers the entire body. 



September 2 : Is feeling well in every away and eruption has disappeared. 



September 4: Discharged. 



Remarks. — This case, as shown by the clinical record and the chart, is typical 

 of severe dengue, but the initial eruption was more marked than in any of our 

 cases. The patient suffered greatly from the headache and the muscular pains. 

 He repeatedly stated that he felt as though every bone in his body had been 

 broken. 



The temperature chart presents a high range of fever, with not as marked a 

 period of remission as is generally observed; it will be noted that morning remis- 

 sions occurred regularly, but that in the afternoon the temperature ascended, 

 reaching 104° F. on three consecutive days; a more permanent remission occurred 

 upon the fifth day, succeeded upon the sixth by the final rise and the caisis, the 

 temperature reaching normal upon the seventh day. 



An eruption appeared in this case upon the first day (the so-called initial 

 eruption), extending over the chest, abdomen and thighs. The typical dengue 

 eruption occurred, as is usual, during the crisis, and was very profuse, extending 

 over the entire body, even the hands and feet being covered with it. The severe 

 initial eruption in this case is veiy unusual, and it is most interesting to find, 

 upon reference to the clinical history of Case 2, from whom this man was inocu- 

 lated, that an eruption occurred in this case also upon the second day of the 

 disease. 



Experiment No. 10. 



Case 10, Chart 10. — B. S., first-class private, Hospital Corps, United States 

 Army. On August 31, 1906, at 12.15 p. m., this man, who had been on duty at 

 the Division Hospital for weeks and had not been exposed to dengue, was given 

 an intravenous injection in the arm of 3.75 cubic centimeters of normal salt solu- 

 tion containing 20 minims of dengue blood from Case 87 (Chart H). Ten cubic 

 centimeters of blood was taken from the medium basilic vein of Case 87 at 10.30 

 a. m., August 31, diluted with normal salt solution, and filtered through the 

 same filters used in Case 9, the filter being controlled as has been described. This 

 filtered blood was used for the inoculation. The patient from whom the blood 

 was obtained was suffering from a rather severe attack of dengue, and the blood 

 was taken on the fourth day of the disease. 



After inoculation with the filtered blood no symptoms appeared in Case 10 until 

 midnight of September 3, but upon referring to the temperate chart it will be 

 noticed that he had fever at least sixteen hours before he complained of any 

 symptoms. If we assume that the first rise in temperature indicated the onset 

 of dengue, the incubation period must have been about two and one-half days, 

 while if the chill, which was the first symptom the patient noticed, is considered 

 as marking the onset, the incubation period would be just three days. We con- 

 sider that the incubation period in this ease was two and one-half days. The 

 following is a resume of the clinical record of this case : 



August 31: Inoculated intravenously at 12.30 p. m. with 20 minims of filtered 

 blood from Case 87. 



September 1 : Was restless last night but at noon to-day feels well. 



September 2 and 3 : Feeling well. 



September 4 : Had chill last night about midnight. This morning complains of 

 pain in the muscles and bones, especially of the arms. His eyes ache and are 



