HISTORY 



1567 



doctors, such as Pancorvo and others in 1875, and French surgeons, 

 such as Fournier in 1874, Bourse in 1876, and Tupper in 1877. 

 During this period there was much disputation as to whether Oroya 

 fever was related to verruga, or was a distinct cHnical entity. In 

 1885 Daniel A. Carrion, a student of the Faculty of Medicine of 

 Lima, who had for some time been studying the disease, attempted 

 to settle this question by vaccinating both his arms with the blood 

 from a verruga tumour on August 27, 1885, and on September 17 

 he began to suffer from the symptoms of Oroya fever, from which he 

 died on October 5. In honour of his noble attempt to elucidate 

 the aetiology of the fever, his compatriots have since referred to 

 Oroya fever as Carrion's disease. 



The unfortunate death of this brave young man stimulated 

 inquiry, and a very large number of investigations were published, 

 of which it is only possible to mention a few. 



In 1885 Izquierdo announced the discovery of a bacillus in some 

 specimens sent to him in spirit, which, of course, prevented anything 

 of the nature of a thorough bacteriological investigation. 



In 1887 Florez grew a coccus on agar-agar inoculated with the 

 blood from persons suffering from verruga. In 1898 a most elabor- 

 ate monograph by E. Odriozola appeared, which the reader inter- 

 ested in the subject is strongly advised to peruse. 



In the same year Nicolle and Letulle independently described 

 bacilli resembling those of tuberculosis in the skin lesions. Barton, 

 in 1902, published the first careful bacteriological examinations of 

 Carrion's fever, and from 1903 to the present time Biffi has written 

 a series of able papers on the disease. 



We are therefore confronted with two conditions described by 

 authors — ^viz., a disease which may or may not begin with fever, and 

 which ultimately ends with a most peculiar and typical eruption, 

 verruga peruviana, and another disease characterized by an incuba- 

 tion period of twenty-one days, as proved by Carrion's inoculation, 

 and of a severe type often ending in death, without the appearance of 

 any eruption. Are these two conditions one and the same disease — 

 that is to say, is Carrion's fever Peruvian wart without an eruption, 

 or are the two separate pathological entities? Tasset, in 1872, 

 held that they were separate entities, and that Carrion's fever was 

 a typho-malarial fever, but since the inoculation of Carrion most 

 authors have considered the two diseases to be one and the same, 

 though every now and again some author has objected, and has 

 held that Carrion's fever was typhoid. In 1901-02, Barton, as 

 the result of careful bacteriological researches, concluded that in 

 the blood and organs of persons dying from Carrion's fever a micro- 

 organism could be found which, though similar to Bacillus coli 

 communis in many respects, was easily separable therefrom. This 

 organism was fatal to inoculated animals, causing a septicaemia 

 and, it is said, a verruga-like eruption in the skin. Bifii has carefully 

 investigated this bacillus, and finds that it is present constantly and 

 in abundance in persons suffering from Carrion's fever, but is 



