16

The case at first was thought to be one of pneumonia, as there were slight
physical signs at the base of both lungs. The lung condition, however, soon
cleared up and at no time was it sufficient to account for the continued fever
and the prostrate condition of the patient. Death took place from cardiac failure
on the thirteenth day of illness.

      On the eleventh day of the illness the serum agglutination reaction with M.
Melitensis was tested by us. At that time the only strain available was the
stock. With an emulsion of this race a complete reaction was obtained in
dilution of 1 in 1200.

      Case XIII.—Mian Jan; aged 23, Sepoy, 27th Punjabis, Multan. Patient
was admitted into hospital on 17th April 1905 suffering from fever. The fever,
which was of a remittent type (vide chart XIII) continued uninterruptedly for
nearly seven weeks, when the patient was sent "away" or " placed on" on sick
leave. There were no joint pains at any time. During the second week, when
the evening temperature daily rose to about 103° F., there was considerable
abdominal pain accompanied by vomiting. This, however, soon passed off under
treatment.

      The agglutination reaction of the serum with M. Melitensis was estimated
on two occasions, first at the end of the second week, and again at the beginning
of the fourth week. The result, the same on both occasions, was as follows:—

      Case XIV.— Abdulla; aged 48, prisoner in Ferozepore Jail. Patient
was admitted into hospital on 1st March 1905. On admission it was noted
that there was slight fever accompanied with cough. The throat was some-
what congested. There was no enlargement of the spleen. The patient was
under observation for more than ten weeks, when he left hospital on being
discharged from Jail. During all this time the fever continued. (Vide chart
XIV.) There were no marked symptoms. At times there were slight cough and
expectoration, but no physical signs of disease could be detected in the lungs.
The sputum was examined on several occasions for tubercle bacilli, but the