205 
the spleen of cases of Mediterranean fever. The path of absorption 
may be through the nares, throat, respiratory passages, and alimentary 
canal. Dry dust contaminated with the urine of cases of Mediter- 
ranean fever has given rise to infection in goats, but not in mon- 
keys. The experience gained during the work performed in Malta 
during 1904-5 has convinced Horrocks that men are more susceptible 
than monke}"S and goats. Shaw's work on ambulatory cases of Med- 
iterranean fever among the Maltese has also shown that opportunities 
for the creation of infected dust are plentiful in Malta. Infected 
dry dust as a cause of Mediterranean fever can not therefore be dis- 
carded. IVhen infection is acquired in this manner the incubation 
period is probably at least a month. 
Mediterranean fever can be acquired by the absorption of infected 
goat’s milk from the alimentary canal. The incubation period in 
this case is also probably long, and may even extend to two months. 
This mode of infection probably plays a great part in the causa- 
tion of Mediterranean fever among the Maltese, who drink raw milk 
drawn at the doors of their houses. 
Horrocks® found that the J/. melitensis could be recovered from 
khaki cotton, khaki serge, and blankets up to the eightieth day. 
Shaw recovered it from blue serge up to the seventy-eighth day. 
The above results obtained by Horrocks upon the longevity of the 
organism upon khaki, cotton, etc., are important as showing the pos- 
sible relation of fomites to the transmission of the disease. 
The presence of ambulatory cases of Malta fever must be taken 
into account in the spread and continuance of the disease in Malta. 
These ambulatory cases constantly pass the specific organism in their 
urine and are undoubtedly as much a source of danger to those with 
whom they come in contact as are the bacillus carriers in typhoid 
fever. 
The usual source of milk in Malta is the goat.^ These animals 
are driven about the streets and milked at the customer’s door into his 
own container. The udders, which are abnormally large, often touch 
the ground and are very liable to be soiled. There are so many herds 
that it is often difficult for a householder to tell the source of his milk 
supply. Xo regulations are in force for the effectual control of these 
vendors. 
It was first shown by Zammit ® that goats could be infected by feed- 
ing them with the J/. melitensis. Zanmiit informed the chairman of 
® Reports of the commission * * * fo^. investigation of Mediterranean 
fever * * *. part 4, 1906, p. 176. 
^ Reports of the commission * * * investigation of Mediterranean 
fever * * *. Part 2, 1905, p. 11. 
® Reports of the commission * * * for the investigation of Mediterranean 
fever * * *. Part 3, 1905, p. 2. 
