17

result of these examinations was always negative. No complaint of pain in the
joints was made.

      At the beginning of the tenth week the blood was sent to us for examination.
The following was the result of the serum agglutination test with M. Melitensis:—

      It was unfortunate that this patient was discharged from hospital before a
splenic puncture could be done.

      Case XV.—Mr. J. D.; aged 22, Lahore. Patient was admitted into
hospital on the 5th May 1905 suffering from fever. For temperature vide
chart XV. The fever, which was of a markedly remittent type, continued
for more than ten weeks, when the patient passed out of observation. Neither
the spleen nor liver was enlarged. Constipation was troublesome at intervals
throughout the illness. During the fifth week the left wrist-joint became swollen
and painful. No other joints were affected.

      At the beginning of the ninth week the serum agglutination reaction with M.
Melitensis was tested with the following result:—

      Case XVI.—Mrs. P., aged 28, Lahore. Patient was admitted into
hospital on 26th May 1905 with a history of having suffered from fever for
twelve days before admission. During the third week patient was very ill, the
temperature on one occasion running up to over 105° F. (vide chart XVI).
The spleen was slightly enlarged; the liver remained normal. Constipation was
very troublesome throughout the illness, an enema as a rule being required to