MALTA FEVER. 45 1 



spirilla to an end, clumps them, and causes their disintegration ; 

 and further, that when the spirilla and the immune serum were 

 injected in one case into a fresh monkey no disease developed. 

 In opposition to Soudakewitch, Lamb found that with a monkey 

 from which the spleen had been removed and inoculation prac- 

 tised death did not occur. Here it is to be noted, however, that 

 the animals used by Soudakewitch and by Lamb were of differ- 

 ent species. 



In the case of the human subject it has been found that a 

 second attack of the disease can follow the first after a com- 

 paratively short period of time, and it is often said that one 

 attack does not confer immunity. It is probably rather the case 

 that the immunity conferred is of very short duration. The 

 course of events in the disease might be explained by supposing 

 that immunity of short duration is produced during the first 

 period of pyrexia, but that it does not last until all the spirilla 

 have been destroyed, some still surviving in internal organs. 

 With the disappearance of the immunity the organisms reappear 

 in the blood, thie relapse being, however, of shorter duration and 

 less severe, than the first attack. This is repeated till the 

 immunity lasts long enough to allow all the organisms to be 

 killed. Lamb's observations suggest the probability that this 

 immunity after the crisis may be evidenced by bactericidal 

 powers in the serum, and according to the recent work of 

 Sawtschenko and Melkirh, there are developed during the dis- 

 ease both an immune body and an agglutinin {vide chapter on 

 Immunity). The former, in association with the alexine of the 

 blood serum, brings about a bactericidal effect, whilst by itself it 

 also constitutes the means whereby a positive chemiotaxis is 

 exerted on the leucocytes. It is further to be noted that re- 

 lapsing fever is unique amongst bacterial diseases affecting the 

 human subject, in respect of the enormous numbers of organ- 

 isms which can be observed in the circulating blood during life. 



Malta Fever. 



Synonyms: — Mediterranean Fever. Rock Fever of Gibraltar. 

 Neapolitan Fever, Etc 



This disease is of common occurrence along the shores of the 

 Mediterranean and in its islands. By means of the agglutinating 



