370 '^^^ Philippine Journal of Science isis 



I was detailed to Buhi to investigate this disease, and re- 

 mained there from October 30 to November 4, 1912, inclusive. 

 At the time of arrival the severity of the epidemic had abated, 

 and there were no more of the rapidly fatal cases. However, 

 some 18 persons were seen who were suffering from a type of 

 inflammation which they alleged was of the same nature as that 

 of the earlier fatal cases. There were 3 or 4 fairly severe cases, 

 and 1 case, a woman of 90 years, died November 3. 



The patients were questioned as to the history and symptoms 

 of the disease, and some of them were visited on 3 or 4 succes- 

 sive days. Temperature and pulse were taken of some 13 of 

 the more severe cases. Blood, and, where obtainable, pus was 

 examined microscopically, by culture, and in some cases imme- 

 diately inoculated into guinea pigs. In 1 case cultures were 

 made of blood from a vein of the arm. 



The patients were for the most part adults, although there 

 was one 7 years old and another 2 years and 8 months. There 

 were 11 females and 7 males. 



As to the lesions, the one common to all cases was swelling, 

 often but not always painful, usually rather diffuse, but in some 

 cases well defined and varying from a small lump to a tumor the 

 size of half an orange. There was no tendency to localize in the 

 joints or in the inguinal or axillary glands. The locality of the 

 lesions was as follows: arm, or hand and arm, 7; foot, 3; leg 

 below knee, 2 ; thigh, 1 ; face, 2. The lesions were usually located 

 on one side or the other with no tendency to right and left sym- 

 metry. 



As a rule there was no tendency of the lesion to come to a 

 focus with pus formation, unless some surgical or cauterizing 

 remedy had been applied; but in 2 cases not thus treated ab- 

 scesses had formed. In about half the cases the lesion was said 

 to have begun at some definite point on the skin and to have spread 

 from it. In 4 cases the starting point was described as a 

 pimple, and in 1 as "like an ant bite" on the finger. In 5 or 6 

 cases the lesion was said to have begun at an extremity, usually 

 the fingers, and to have extended up the arm or leg. Three 

 cases showed a vescicular eruption over the lesion. 



The temperatures of 13 of the more severe cases were taken 

 by mouth, some of them on 3 or 4 successive days. In 6 cases 

 there was a temperature of 100° or over, in one, 102° ; the rest 

 ranging from 99°. 5 to normal, and exhibiting no more temper- 

 ature than would be expected in a patient suffering from a 

 minor inflammation. 



