TYPHUS FEVER IN INDOCHINA. 137 



The origin of our little localized epidemic must either be from the 

 villages of our coolies or the boat which carried them. The infection 

 may be developed later, but the germs seem to come from the south of 

 Tonquin. The first three cases belonged to the same village, Coi Tri 

 (Ninh Binh), and the other two to a bordering province, Nam Binh. 

 The boat need not be considered, for if the disease had originated in it, 

 the number of typhus cases would not have been so limited and there 

 would certainly have been a focus on board, which could not have 

 remained long unnoticed. Moreover, it was a Tonquinese vessel, the 

 home port of which was Haiphong. Inquiry which will be made in the 

 incriminated Tonquinese provinces will soon make it certain whether 

 typhus fever has taken root in Tonquin, and whether new sanitary 

 supervision will not be justified. 



CONCLUSION. 



1. Typhus fever has been observed in Annam in natives who recently 

 arrived from Tonquin. 



2. It manifested itself in accordance with the classic description, with 

 the exception that the erujnion was wanting. 



3. The direct inoculation of blood from man to man has reproduced 

 the disease after an incubation period of fourteen and twenty-one days. 



4. Typhus fever seems to be a blood disease transmitted to man by 

 bites of insects. 



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