47

CHAPTER.

BLACK-WATER FEVER NOT DUE TO A SPECIAL PARASITE.

   INFECTIVITY OF BLACK-WATER FEVER.—There is nothing in the general
clinical picture of Black-water Fever to suggest that it is an infectious dis-
ease, such as Yellow Fever, or Sprillosis; epidemics have, it is true, been, described,
but with a want of accurate and detailed observation, which renders it impos-
sible to judge whether they have been, merely the result of large numbers of per-
sons being placed simultaneously under Black-water Fever conditions, or due
to the spread of infection.

   If malaria will produce Black-water Fever in fifty per cent. of the new-
comers in, a small community, there is no reason why in the case of a large num-
ber of susceptible persons brought more or less simultaneously under Black-water
Fever conditions, there should not result a large number of cases simulating
an epidemic. To quote, without particulars, epidemics of the disease on,
railways or in, armies has therefore little bearing upon, the question.

   In, the Duars attacks occur quite independently of one another in widely
separated gardens and districts. The incidence, as we have pointed out, shows
a frequency directly relative to that of malaria; and we have seen, that attacks
are more frequent in, certain, bungalows, in which there is especial danger of con-
tracting the disease. In such bungalows attacks occur generally at long and
irregular intervals; but in regard to length of residence of those attacked they
conform to the general rule.

HISTORIES.

         Neora Nuddy.—A bungalow with rarely more than one European.

         P. attack September 1897, after 8 months' residence.

         L. attacked October 1905, after 7 months' residence; second attack in December
               1905.

   S. attacked January 1907, after one year's residence.

Note.—The early onset of the disease under especially intense malarial conditions.
Barons.—

(a) Assistants' bungalow. Two men resident.