18

procure an evacuation. Quinine was without effect. There were no joint pains
complained of at any time.

      The serum agglutination reaction with M. Melitensis was estimated in the
middle of the seventh week. The following was the result :—

      Case XVII.—Amalak Shah, aged 17, an albino. Patient first came
under medical observation on the 19th June 1905. He stated that he had been
suffering from fever for a day or two before this date. He was resident in Murree.
For temperature vide chart XVII. It will be seen that on occasions a high tem-
perature, over 105° F., was recorded; its remittent nature was fairly well marked.
Profuse perspiration was a prominent symptom throughout. About the middle
of the fourth week he first complained of pain in the joints; at this time the
right hip was affected and later on the joints of the toes became involved.
Further, he complained of pain in the muscles of the thighs and back. Con-
stipation and diarrhœa alternated. At one time faint sibilant rales were heard
over both lungs. This bronchitis, however, soon passed off.

      The serum reaction with M. Melitensis was tested in the middle of the third
week with the following result :—

      This case completes the record of the cases of Mediterranean fever which
have come under our observation at the present time. We have, however, still