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39.2°C. to 41.2°C. which it maintains for a brief period ; it then falls
quickly or gradually, to a normal or a subnormal minimum, either at the
same time, or just previous to the first appearance of the hæmatozoon
in the gluteal circulation. Vide Charts, Cases Nos. L, XIV, LVIII,
VIII, XIX, XL.
(ii) The Temperature from the discovery of the hæmatozoon in the blood,
until death.—The type of fever appears to vary in different outbreaks
of Surra, changing according to the locality in which it occurs, and the
animal affected. In Burmah, Steele described the fever in mules as
being of a relapsing type, and there is no doubt, that the charts record-
ed in two cases of the naturally contracted disease bear out his opinion.
In the cases which have come under our observation, animals suffering from
the naturally contracted and inoculated disease, present at least two
varieties or types.
(i) A continued fever accompanied at tolerably frequent intervals by remis-
sions more or less marked, and after a varying period of days, by an
intermission of longer or shorter duration. These changes may be
repeated several times in the course of the disease. When, however, it
arrives at its last stage, the thermometer reveals a continued high
temperature of a remittent type, or one characterised by morning re-
missions, and evening exacerbations until death.
(ii) A second and much rarer form is one which may be conveniently divid-
ed into three stages : in the first, a continuous fever, accompanied by
remissions, is present for some days. This is followed by a succession
of periods lasting two to five days, each individual period being made
up of a gradual, or more sudden rise from the normal to 40° or 41°C.,
or even higher, when it attains a maximum, and after a short time is
followed by an abatement of the fever, indicated by a sudden fall in
temperature from 2° to 4°C., which may become normal or subnormal,
and on such occasions this is succeeded by a period of apyrexia. In
the third stage the fever may again take on a continued type, which is
not always continuous, but remains high and oscillates freely until
death.
(iii) Cases may be rapidly fatal, with the temperature remaining subnormal
during the whole course of the disease, Vide cases XXXII (35.4°C. to
38°), XXX (35.7° to 38.8°C. just before death), XLI (35° to 37.6°C.),
XXVII (normal and subnormal, never over 38.7C.),
In some instances there may be a sudden rise in temperature just before
death, but in the majority of cases there is a fall. In thirty cases under
our observation, death was followed in eighteen by a fall in the
temperature varying between 05° to 3°C., in ten by a rise varying
between 0.5° to 4°C., and in two, neither rise nor fall took place.
Vide cases XVIII, XXX for falls of 3°C., and cases XXIX, XX, and
XXXIV, for rises of 4°, 2.5°, and 2.8°C. respectively.
4. Moisture.—During the whole course of the disease, until just before
death, when as a rule profuse sweating occurs, this symptom is entirely absent.
b.—MORBID PHENOMENA PRESENTED BY. THE ORGANS OP CIRCULATION.
1. The Pulse.—This is accelerated ; it ranges between 30 and 90, and may
each 120 just before death, but varies considerably in the different types of cases
recognized in this disease, not only in frequency, but in rythm and force. At the
commencement the pulse increases in frequency upon the first rise of temper-
ature, and continues to do so, as long as the temperature becomes elevated,
during the latent period of the disease ; on the appearance of the organism in
the blood the pulse may fall somewhat, but again rises and remains so during
the paroxysm of fever, until the first apyrexial period, when it again falls to
normal or thereabouts, A repetition of the above is observed in each fever
and fever-free period, until towards the termination of the case by death,
when the pulse increases in frequency, and at the time of death may attain 120
beats to the minute, or even more. It will be of interest to examine the charts