HISTORY— SYMPTOM A TOLOGY 



1503 



Ricketts and Wilder, in 1910, in typhus. In 1917 Da Rocha Lima 

 called the bodies found in trench fever Rickettsia quintana, to dis- 

 tinguish them from those found in typhus {R. prowazecki) and 

 those occasionally seen in normal lice [R. pediculi). These findings 

 were supported in 1918 by Arkwright, Bacot, and Duncan. 



In 1919 Bradford, Bashford, and Wilson described minute bodies 

 which they had succeeded in cultivating from the blood of patients, 

 using Noguchi's method of anaerobic cultures. These bodies are 

 morphologically identical with Rickettsia bodies, but they are 

 Gram-positive. 



Climatology. — ^The disease is known to exist in England, Flanders, 

 France, Salonica, Greece, Macedonia, Tyrol, Galicia, Poland, Russia, 

 and Mesopotamia. 



etiology. — The aetiology has not been completely elucidated. 

 Toepfer first found minute bodies in the intestinal contents of lice 

 fed on trench fever patients, which he considered to be Rickettsia 

 bodies; these bodies were somewhat similar to those found in 

 Rocky Mountain fever and typhus. Toepfer's work was confirmed 

 and enlarged by Da Rocha Lima, who called the parasite Rickettsia 

 quintana, and more recently by Arkwright, Bacot, and Duncan. 

 These latter authors describe the bodies as being minute Gram- 

 negative organisms, round, oval, or lancet-shaped diplococci, 

 0*3 microns in their shorter diameter by 0-3 to 0-4 in length; the 

 first appearance in the excreta of lice being as a rule eight to ten 

 days after the first infecting feed. They seem to be slightly smaller 

 and less frequently lancet-shaped than those found in typhus. The 

 size of these bodies is such that they should not pass as a rule a 

 bacterial filter, but may occasionally pass a filter which retains 

 such bacteria as B. typhosus. 



Bradford, Bashford, and Wilson report that they have cultivated 

 from the blood of patients, by using Noguchi's method, minute 

 bodies which seem to be very similar to Rickettsia bodies, but are 

 Gram-positive. 



The trench fever virus is considered to be a resistant filterative 

 virus by the American Commission. This Commission (composed 

 of Strong, Swift, Opie, Macneal, Baetjer, Pappenheimer, Peacock, 

 and Rapport) carried out a very thorough investigation in 19 18, and 

 came to the conclusion that the virus was carried from the sick to 

 the healthy by the agency of the clothes louse, Pediculus corporis 

 de Geer, 1778, and that it was usually conveyed by the bites. 



The War Office Commission (composed of Byam, Carroll, 

 Churchill, Dimond, Lloyd, Sorapure, and Wilson) came to the 

 conclusion, after a series of important experiments, that the infec- 

 tion was contaminative by means of the louse faeces infecting 

 scratches on the skin. 



Pathology and Morbid Anatomy. — ^Unknown. 



Symptomatology — Incubation. — Clinically the incubation period 

 is believed to vary from fourteen to thirty days, because this is 



