YELLOW FEVER EXPEDITION 
527 
Case 1. Live in chalet G. This chalet is very full of mosquitoes, partly 
S.fasciata, chiefly bred in* the ant guards of the pillars supporting the house, and 
partly with C. fatigans, probably from the stables. Arrived in Para, from France, 
July 14, 1900. (Two other occupants of the house arrived in April ; they were not 
attacked) ; sleeps with inefficient mosquito net. 
Sept. 15. Taken suddenly ill in evening ; at 8 p.m., temp., 40 s . 
,, 16. Face and eyes injected ; skin, flushed ; no headache or pains ; no vomit ; skin dry - t 
tongue, central fur and very red edges ; no icterus ; no albumin ; gums not 
swollen ; slight injection of fauces. 
„ 17. Still flushed ; hardly conscious; some albuminuria ; no icterus ; spleen and liver, 
nil. 
„ 18. Still flushed ; temperature falling ; fair quantity of albumin in urine ; no icterus. 
,, 19. Feels better ; no icterus ; gums not swollen. 
,, 20. Some epistaxis ; gums slightly swollen ; (?) slight conjunctival icterus. 
,, 21. Some epistaxis ; gums much swollen. 
„ 22. No epistaxis ; bleeding now from gums. 
,, 23. Distinct conjunctival icterus ; gums bleeding ; albuminuria. 
„ 26. No icterus ; feels weak. 
Oct. 2. No albumin ; appetite returned. 
Case 3. Middle aged, hearty but spare ; cowkeeper, lives at stable ; takes meals 
in chalet G. Arrived with wife from France and came straight to Institute. 
Oct. 1. Taken ill in the afternoon ; temp., 39°. 
„ 2. Complains of frontal headache and lumbar pain ; temperature normal ; no sweating \ 
examination of blood for ague parasites negative ; spleen and liver, nil ; eyes 
rather injected. 
„ 3. Eyes injected ; epigastric pain and frontal headache ; tongue, much moist white fur ; 
no icterus ; much bilious vomiting ; no albuminuria. 
„ 4. Headache persists ; no icterus ; bilious vomiting, returns all ingesta ; abdomen not 
tender ; tongue, much white fur ; acute epigastric pain relieved by vomiting ; 
much albumin in urine ; blood examination negative. 
„ 5. Less pain ; abdomen rather tender ; insomnia ; much albumin ; no vomiting ; no 
icterus 
„ 6. Pain slight ; generally better ; albumin moderate ; no icterus ; weak and emaciated. 
Further history : no icterus ; no haemorrhage ; gums, nil. 
Intermediate between these two cases a labourer living at the further end ot the 
grounds was taken with fever. After four days, when the effect of the quinine which 
he had taken had passed off, quartan parasites were found in his blood. 
Case 4. Brazilian, has lived many years in Rio de Janeiro. Twelve months 
ago spent some months in Europe, on account of severe attack of fever (malaria). 
Has lately been paying a good deal of personal supervision about the cowsheds and 
stables. 
