134 YEKSIN AND VASSAL. 



(Keed, Carroll, Agramonte and Lazaer, Marchoux, Salimbeni and 

 Simond). With regard to dengue we have profited in the same manner 

 during the last j'ear (Ashburn and Craig) . 



Case VI. — Nguyen van Ky, coming from the village of Nam-Dinh, Van-Khan 

 ( Province of Nam-Dinh, south Tonquin ) , was admitted into the native hospital 

 for ulcers on the legs. His general state of health was excellent. Of robust 

 constitution with a normal heart and without any symptoms of morbid diathesis, 

 this man submitted voluntarily to an inoculation, of which the probable results 

 were not unknown to him. 



On June 1 Nguyen van Ky was inoculated under the skin of the arm with 

 0.50 gm. of blood taken from one of the veins of the arm of Tran Luan (Case 

 V), who was in his second day's illness. The blood collected in a syringe, 

 previously sterilized by steam, was immediately injected without the addition of 

 any foreign substance. There was no reaction at the site of the inoculation. 

 The lymphatic glands of the arm did not show the slightest modification. 



The period of incubation lasted fourteen days. Suddenly, without any pre- 

 monitory symptoms, the patient was seized with an intense fever which persisted 

 for eleven days with slight variations, giving a most characteristic chart, 

 identical in character with the ones taken from the natural illness. The tem- 

 perature passed in one night from 35°.7 to 39°. 5 C. The symptoms of the natural 

 disease were reproduced with the greatest clearness and in addition congestion- 

 of the lungs was noted. The excessive prostration of the patient, his wandering 

 thoughts, his insomnia, anorrhexia, coated tongue, constipation, the absence of 

 intestinal phenomena, the suddenness of the attack and the rapid recovery after 

 the crisis, were presented in detail. There was neither eruption nor spots on 

 the skin, but the conjunctiva? were as usual congested. 



As in the other cases, our microscopic researches were negative, and no 

 specific febrifuge medication was successful. 



Case VII. — Tran Minh, 21 years of age, from the village of Do Le (Province 

 of Ha-Nam, south Tonquin), entered the hospital on May 28, 190G, for fever and 

 itch. His blood contained Laverania malaria, and he had a series of irregular 

 paroxysms which were checked by quinine. On the twentieth day in the hospital, 

 when our patient had entirely recovered from his attacks of fever and when his 

 blood contained no more hrematozoa, we proposed to him that he should be 

 inoculated with the blood of a typhus patient, at the time warning him of the 

 probable consequences. 



On June 20 he was inoculated under the skin of the arm with the blood of 

 Nguyen van Ky (Case VI), who was in the fifth day of his experimental disease. 

 The technique followed was the same as it was in the first instance. The amount 

 of blood injected was 0.50 gm. and it was absolutely pure. The incubation period 

 upon this second passage was longer than it was with the first patient, it being 

 twenty-one days instead of fourteen. There was no local reaction. 



As is seen from the chart, the temperature rose abruptly and remained at a 

 high level for twelve days. It was impossible not to recognize the almost mathe- 

 matically exact repetition not only of the fever, but of all the other symptoms. 

 We again observed the identical signs; i. e., the abrupt beginning and end, the 

 great weakness, the plague-like delirium, the constipation, insomnia, absence of 

 eruption, blood-shot eonjuctivo?, the inefficacy of quinine, and the absence of 

 blood parasites. 



