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become affected. After this, a man called Melcha took the
disease. Then Illal's household became affected, and four of
his people are still ill. Two men died of the disease in
separate houses, but the family of one of them were not
affected. This illness commenced about a month ago with
feverish symptoms and diarrha, then his spleen became
enlarged and he began to lose flesh.
Present condition is weak, thin, and anmic. Has slight
anasarca, appetite bad, slight looseness of the bowels; spleen
enlarged to 10 fingers below the ribs. Abdominal pain.
The man remained 31/2 months in hospital, and, in spite of
continuous anti-malarial treatment, grew steadily worse, had
repeated bowel attacks, and died from an attack of pneu-
monia.
He is recorded as having fever pretty regularly at
some portion of the 24 hours. In spite of this, his tempera-
ture, with one or two slight rises, remained subnormal during
the whole of his stay in hospital, often not reaching the nor-
mal for a week together. During the last fatal attack of inter-
current pneumonia, it ran up to 103, and remained above
normal for some days. It had, however, been again subnormal
(95.8.) for some days before his death. The Hospital-Assistant's
puzzlement at having to do with a case of fever, which the ther-
mometer persistently belied, is betrayed by such phrases as "No
fever now, but had fever during the night," never apparently
suspecting that the man had no fever at all, and that his saying
he had had it, merely meant that he felt ill, and that, like most
sick people, he felt worse at certain periods of the 24 hours
than at others. Anti-malarial treatment had a fair trial in this
case. Quinine in 16 grains doses, arsenic, iron, and iodine were
all tried, and persevered in; but, in spite of the fact that the
man's case was at first by no means serious, and had only
lasted a month, under this treatment the man steadily grew
worse instead of better. Considering that the only symptom-of
malarial poisoning in this case was a moderately enlarged
spleen, such as is found in immense numbers of Indians, to
all appearance enjoying very fair health, this result is by
no means surprising.
Post-mortem examination twelve hours after death.-
Body emaciated, not darker than usual. Feet dematous.
Section of tissues anmic.
Thorax left plural cavity contained fluid of a slightly
turbid character, pleura congested and rough. Posterior