22 ASHBURN AND CRAIG. 



February 13: The patient is hungry, the eruption lias disappeared, the glandu- 

 lar enlargement is less marked and the urine is normal. 



February 19: Patient is still improving. Widal reaction was negative after 

 one hour. No malarial parasites found in the blood. 



Lieutenant Brans made daily notes on these cases, but when there was 

 no change in the condition or no new examination mentioned, the remarks 

 have been omitted. Both patients received cold baths during the progress 

 of the disease and the charts are probably modified by them. While the 

 notes do not indicate it, such is probably the explanation of the two 

 marked drops of temperature shown by Charts B. A satisfactory diag- 

 nosis was never made on either case, although both were reported as 

 being typhoid fever. 



We do not maintain that these cases were tswtsugamushi disease, but 

 they certainly present enough points of resemblance to it to make it 

 worth while for medical men in the Philippines to keep the matter in 

 mind, should they have the opportunity of investigating similar infections. 



ACKNOWLEDGMENT. 



We desire to express our thanks to those assisting us in this study, 

 and particularly to Professor Miyajima and his fellow-workers from the 

 Imperial Institute for Researches of Infectious Diseases, to whom we 

 are indebted for the opportunity to see what we did of tsutsugamushi 

 disease and for such knowledge as we have of the articles published on it 

 in Japanese, as well as for the information they gave us concerning their 

 own work. We are also indebted to Lieutenant Brans, for his notes on 

 the Camp Connell cases. 



BIBLIOGRAPHY. 



TSUTSUGAMUSHI DISEASE. 



Balz, E., and Mawakami. 



Die Japanische Fluss — oder Ueberschwemmungsfieber. Arch. f. path. Anat. 



Berl. (Virchow's Arch.) (1879), 78, 373. 

 Nachtrag zu dem Aufsatz fiber Flussfieber. Ibid., 528. 

 Ogata, M. 



Vorlaufige Mitteihmg iiber die Aetiologie der Tsutsugamushi (Kedani) . 

 Krankheit. Deutohe Med. Wchnsch. (1906), 46, 1886. 

 Palm, Th. A. 



Some Account of a Disease called Shima Mushi or Island Insect Disease 

 by the Natives of Japan. Edinb. Med. Journ. (1878), 128. 

 Tanaka, Keisuke. 



Ueber Aetiologie und Pathogenese der Kedani Krankheit. Centralb. f. Bak- 



teriol. (1899), 26, 432. 

 Ueber meine Japanische Kedani Krankheit. Ibid. (Orig. ), 42, 16, 104, 

 235, 329. 

 There is a quite an extensive Japanese bibliography on this disease which 

 is not cited as it was not accessible to us and would not be to most of our 

 readers. 



