28 



manifested. In some of the severer forms of yellow fever the tern 

 perature is occasionally prolonged for two to three weeks, and som 

 of the accompanying symptoms are, in some of these cases, suggestiv 

 of typhoid. Typhoid fever, in the second or third week, will giv 

 the Widal reaction and Eberth's bacillus may be isolated from th 

 blood. These are, of course,, absent in yellow fever. 



Acute yellow atrophy oftlie liver. — This is a very rare disease. I 

 occurs most commonly in women, and in these more particularly dur 

 ing pregnancy. The disease is ushered in like a case of catarrha 

 jaundice. A marked and rapid reduction in the size of the liver i, 

 distinctive. 



In yellow fever the size of the liver is unaffected. In malignan 

 jaundice albuminuria is of frequent occurrence, but it is not as markec 

 nor as constant as in cases of yellow fever of the same degree of viru 

 lence. The duration of over 75 per cent of the recorded cases o: 

 malignant jaundice has been in excess of seven days; the duration o: 

 almost 75 per cent of the cases of yellow fever does not exceed sever 

 days. An early fatal termination in such a case would decidedly favoi 

 a diagnosis of yellow fever, but a later termination should not, how 

 ever, be regarded as excluding yellow fever. 



Weil's disease. — This disorder is characterized by fever, intens< 

 jaundice, swelling and tenderness of the liver, diarrhea, .notabh 

 enlargement of the spleen, and nephritis. In yellow fever neithei 

 liver nor spleen are enlarged, a tendency to constipation is the rule 

 and in cases of a corresponding grade of severity, the hemorrhagic 

 symptoms are likely to be more marked and to appear earlier. 



Relapsing fever. — The presence of the Spirochasta of Obermeier ii 

 the blood is distinctive. 



Catarrhal jaundice. — This may in some instances have to be consid 

 ered. In this condition the jaundice appears with little or no elevatioi 

 of temperature, preceded by slight, if any, symptoms of indigestioi 

 and accompanied by clay-colored stools. In yellow fever the jaundice 

 appears after at least two or three days of fever and will be accom 

 panied by the other symptoms characterizing a well-defined attack 

 the stools are not clay colored. 



EEEEEENCES. 



Blanch abd (R.). 



1905. — Lea moustiques. Paris. 



Barreto de Barros and Rodrigues. 



1903.— Experiencias realisadas no Hospital de isolamento de S. Paulo, etc. Rev 

 med. de Sao Paulo, February 28, v. 6, p. 69-73. 



Berry (T. D.). 



1905.— Ability of the larvae and pupae of the Stegomyia fastiala to withstand des 

 iccation. Pub. Health Rep., Washington, v. 20, part 1, p. 1148. 



Carter (H. R.). 



1900. — A note on the interval between infecting and secondary cases of yellov 

 fever, etc. New Orl. Med. & Surg. Journal, May. 



