520 
THOMPSON YATES LABORATORIES REPORT 
and no palpable glands only twice, in one of which the inguinal glands were also 
negative ; of the other there is no note. Of twelve doubtful cases, axillary affection 
was noted in eight, and none in the remainder. In a number of other cases in which 
malaria was present, it was suspected that yellow fever infection was also at work. At the 
general hospital a number of odd cases were examined, as a rule these were negative ; 
however, one batch of seven malaria cachectics gave two with glandular enlargement, 
one unilateral and one bilateral. 
The general plan of palpation was to raise the arm from the side and thrust 
the fingers as high as possible in the axilla, put the arm to the side, and gradually 
work downwards. In some cases the enlargement was only on one side, in others 
on both ; in a few cases there was distinct tenderness, but on the whole this was 
unusual. My colleague made observations on a number of cases from day to day, 
but the records of these have been lost ; the general result was that the glands 
diminished and became unpalpable as the patient recovered. (One record in the 
notes gives enlargement on the fifth and eighth days, which had lessened on the tenth, 
and disappeared on the twelfth day). In my own case I have distinct recollection of 
finding distinct enlargement on one side about the first or second day ; after conva- 
lescence there was nothing palpable. 1 may note here that previously, on October 23, 
I noticed that my right bicipital gland was enlarged and tender, and remained so for a 
few days, there was not sufficient general disturbance to take the temperature ; it was 
ascribed to the effect of a mosquito bite without marked primary lesion. Supposing 
that this really was an extremely mild yellow fever infection, it would account for the 
mildness of the attack which I had some months later, when my comrade — certainly 
infected at the same time, as he was taken ill less than twelve hours after me — had 
so severe an infection. At the same time it may be mentioned that we met with a few 
cases of husband and wife in which both were taken ill on the same day, and yet the 
one died of acute yellow fever whilst the other had so slight an attack that without 
the circumstantial evidence it would hardly have been possible to make a diagnosis. 
Naturally, in these questions individual susceptibility cannot be entirely discounted. 
