X, B, 5 Schiiffner: Pseudotyphoid Fever in Deli 351 
cases may last until the fever has subsided or until the rash 
disappears. 
Finally I would mention the occurrence of rheumatoid pains 
in the smaller joints. This symptom appears sometimes soon 
after the fever has subsided, but does not last more than two 
or three days. 
Convalescence follows a normal course, but it is usually some 
time before the patient is completely well. 
In regard to special methods of inquiry, in all cases agglutina- 
tion tests were applied with the patients serum fer B. typhosus, 
B. paratyphosus A, and B. paratyphosus B; attempts were, also, 
made to cultivate organisms from the blood on suitable media. 
These inquiries, as well as microscopic and bacteriological 
examination of exudate from the initial lesion and of excised 
glands, were entirely without result and gave no hint as to the 
etiological factors concerned in the malady. As it was not pos~ 
sible to infect monkeys by injection of blood from cases of the 
disease, I could not ascertain whether or not a filterable virus 
played any part in its causation. 
In the post-mortem examination of seven fatal cases, I found 
only such lesions as may be present after pyrexia. 
SUMMARY 
1. There exists in Sumatra a disease which resembles enteric 
fever in its general clinical characters, but is clearly distinct 
from that disease in causation. 
2. There is evidence that this disease is transmitted in a man- 
ner similar to that which has been demonstrated for kedani fever 
in Japan. 
3. Though the pseudotyphoid of Deli would appear to be a 
much less fatal disease than kedani fever of Japan, there are 
yet many points of resemblance between the two diseases. 
REFERENCES 
Miyasima, M. Centralbl. f. Bakt——Ref. (1911), 50, 34. 
SCHUFFNER, W., and WAcHSMUTH M. Trans. Bombay Med. Cong. (1909), 
55. 
Ipem. JZeitschr f. klin. Med. (1910), 71, 133. 
TANAKA, K. Centralbl. f. Bakt. (1899), 26, 432. 
