PHLEBOTOMUS FEVER 693 



bearing on the pathology of a group of similar affections 

 occurring in various parts of the world, — chiefly in coastal areas, 

 — and going under a variety of names. Examples are dengue, 

 the three-day fever of various regions, Canary fever, Shanghai 

 fever, Chitral fever, and the seven-day fever or simple continued 

 fever of India. Of these, that presenting the most definite 

 clinical picture is dengue, — a condition for long well known and 

 having an extensive distribution, and it may be said that Ash- 

 burn and Craig in the Philippines found the blood in dengue 

 as in pappataci to be infective even after filtration, the insect 

 host however, being culex fatigans. Whether all these disease 

 conditions are identical, further research must decide ; at present 

 Birt believes that at any rate pappataci and dengue are distinct, 

 and certainly Doerr does not in his description allude to the 

 terminal skin eruption which Manson believes to be of very 

 constant occurrence in the latter. The rarity of a fatal result in 

 these diseases makes their investigation by inoculation of the 

 human subject relatively safe. 



