5o8 
THOMPSON YATES LABORATORIES REPORT 
' Borras ' fever 1 'is a pyrexia most frequently attacking children, though it may 
occur at other ages. It is characterized by vomiting — abundant or scanty — lasting a 
few hours ; or the days of the febrile attack rarely pass without this disturbance ; 
occasionally there is albuminuria but never gastric haemorrhage, epistaxis, melaena, 
petechiae, hiccough, or icterus. It may occur more than once in a lifetime ; both 
whites and coloured are attacked — most frequently whites up to the age of twelve 
to fourteen years ; the mortality may be as high as 30 per cent.' On the other 
hand, Juan B. Fuentes 2 says that haemorrhages occur and that when 'icterus and 
albuminuria are present it may be confounded with yellow fever or icterus gravis.' So 
that there is some degree of uncertainty as to what borras fever is. Anyhow, it is re- 
garded with great suspicion as being merely one of the many clinical types of yellow 
fever ; thus in the report of vital statistics of Habana, etc., for July, 1901, by Major 
Gorgas, we rind : — ' We make the best record ever made before for July, having had 
only four cases and one death. Two of these cases (both of which were reported as 
' Borras ' and one of which died) occurred in children of Cuban parentage, born in 
Habana, having lived in this city continuously since birth. The physicians of Habana, 
as a body, do not recognize this disease as being yellow fever, and indeed, both in its 
symptomatology and pathology, it differs widely from the disease in the adult ; but 
the board, to which all cases of yellow fever are referred, after careful consideration, 
and in one of the cases after a careful autopsy and histological examination of the 
organs, concluded that the two cases were yellow fever.' 
In Para it was seemingly impossible to get people to appreciate the importance of 
the complete diagnosis of malarial fevers by the microscope, and the impossibility of 
doing so in patients filled up with quinine ; consequently we were rarely able to decide 
in mild cases of transient fever which passed as ' febre palustre.' 
In one cottage I came across a family in which two children had recently died, 
and a third was moribund ; the nearest known Anopheles breeding place was fully half- 
a-mile away and separated by trees ; the parents were unaffected. Unfortunately it was 
not possible to make any proper examination, and an autopsy was out of the question ; 
still it seemed clear that some intense infection was present. There was no rash or 
icterus there, the condition of the child seemed almost meningitic. Vomiting seemed 
to have been the chief symptom, besides ' fever.' 
With regard to the ' bilious fever' none of the few cases which I saw diagnosed as 
such, agreed with the symptoms laid down by Torres Homem 5 ; they were all in 
recently arrived individuals, and there ciid not appear any definite reason why they 
should not be classed as yellow fever. In Torres Homem's account we find that 
this bilious fever or ' febre amarelle dos acclimitados ' is very common in Rio, 
especially during the summer (i.e., the yellow fever period), and that it is the dwellers 
1. 
3- 
Luis Perna y Salomo, Rei-ista medicina tropical Habana, Tom II, p. 49. 
2. Juan B. Fuentes, ibid, Tom 1, p. 75. 
Torres Homen, Estudo clinico sobre as febres do Rio de Janeiro, 1877. 
