UNDULANT FEVER 



remittent fever/ distinguishing it clearly from enteric and what he 

 called * Maltese fever.' 



From this date there seems to have been much confusion, for it 

 was often diagnosed as some form of rheumatism, but the disease 

 appears to have been clearly recognized by Boileau, Chartres, 

 Thomas, and others. In 1879 Veale gave an account of it as 

 seen in invalids at Netley, as did Fazio in Naples, who not merely 

 described the disease, but suggested that it might be found to be 

 of bacterial origin. 



In 1886 it was proved to be a separate pathological entity by 

 Bruce, who discovered a micrococcus in the spleen. In 1887 he 

 found the organism several times, and was able to cultivate it on 

 agar-agar, and to reproduce the disease by inoculation in monkeys, 

 from which he again obtained the organism in pure culture. In 

 1889 he published the first full account of the clinical symptoms. 



Fig. 671. — Distribution of Undulant Fever. 

 (After Bassett-Smith.) 



and in 1891 he grew the micrococcus from blood aspirated from the 

 spleen during life. Thus, Bruce proved that this organism, which 

 he called Micrococcus melitensis, was the true cause of the fever. 



In 1897 Wright and Semple showed that the disease could be 

 diagnosed by the agglutination of the micro-organism by the serum 

 of patients, and in the same year Hughes published a full historical 

 and clinical account. 



In 1904 a Commission was appointed by the Admiralty, the War 

 Office, and the Civil Government of Malta to investigate the disease. 

 This Commission (J. C. Kennedy, Zammit, Horrocks) demon- 

 strated that the micrococcus leaves the body mainly in the urine, 

 and is then capable of existing for a long period outside the body. 

 Zammit discovered that the milk of many goats agglutinated 

 M. melitensis, and Horrocks isolated the germ from such goats. 

 It does not appear to affect injuriously such animals living in the 



