17
settled, it was next necessary to decide in what respects that fluid is modified. The
earlier lesions noted were those of simple anaemia, a paucity of red corpuscles, a
shrivelled or imperfect condition of the blood elements, an apparent preponderance of
white corpuscles, which were soon found to be not white but decolorised red ones, a
tendency to dropsy, petechiæ of membranes, cardiac murmurs immediately preceding
death, extreme pallor of membranes, the dry harsh state of the skin and acidity of
urine (as though the animal, for want of sufficient vegetable diet, had to become
practically carnivorous in living on its own tissues); these were conditions enough to
warrant me in seriously considering whether I had not been sent simply to investigate a
disease which I should have to report as under-feeding pure and simple! In starva-
tion there may be exaggeration of normal daily variations in temperature, and a certain
periodicity dependent on the phases of digestion might be present in association with
gastric ulceration, but, as the temperature tracings gradually developed themselves, I
became assured that simple anaemia would not suffice for the explanation of a Relapsing
Fever, nor explain why the disease occurred at certain seasons especially. For some
short time after I subjected the blood to elaborate scrutiny, only small, spherical, mobile,
highly refractive bodies attracted my attention as unusual. I thought they might be
the micrococci of malaria as described by Tommasi Crudeli and others. Soon, however,
the characteristic organisms became evident and at once dispelled, in a most satisfactory
manner, all ideas of typhoid, ulceration of stomach from irritant ingesta, malicious
poisoning, and simple anaemia, but not absolutely the theory of malarial influence.
It may at- first seem strange that with active living beings in the blood Veterinary
Surgeon (First-class) Frost and myself (for a month) had not observed them, but in this
relation it must be remembered that it is only at certain phases of the fever (which
happen to be at the time when the animal is least likely to be brought to the notice of
the veterinary officer) that they are detectable in the blood; secondly, the parasites
are, under ordinary powers, detectible only by most intent observation when we know
what to look for. Dr. Evans' Surra observations " gave us a good lead," but we were
" thrown off the scent " by the gastric ulceration, which induced us to believe that
we had to deal with a disease other than Surra. What led me back to the right track
was especially the markedly relapsing character of the fever as shown by the beautiful
thermographic tracings which the cases afforded in the first month; and, as Relapsing
Fever in man is associated with spirilla in the blood, I was led to seek and find spiral
organisms in mules affected with the British Burma disease. Then, with increased
familiarity with the disease, I found many of the differences between it and Surra (as
observed by Dr. Evans) melt away, and now but few remain. The symptoms in a
pony which obtained the disease artificially almost exactly answered to Dr. Evans'
description of his cases in Punjabi horses.
6. To illustrate the results of clinical observations made by me and to give an
idea of the symptoms and post-mortem appearances found in the
mules, I will insert in the Appendix my note-book records of
clinical work for two days consisting of pulse, temperature, &c.,
records and the results of urine analysis. Also I give the charts
of one ordinary case of the disease, the record case book entries of
two more, the charts of experimental mule cases and of one pony
and one dog case, and the charts of complicated cases as occurring
in the mule. These will suffice as a means of illustration of the
cases to be dealt with in the inquiry, and also as a means
whereby we may compare this Burma disease with Relapsing
Fever as observed in man and Surra as studied by Dr. Evans in and about Dera Ismail
Khan. In comparing Surra with the British Burma disease, I have had the benefit of
Dr. Evans' opinion after personal examination of Burma cases. He was inclined to
consider the two diseases as distinct, but closely allied, rather than essentially the
same disease modified by difference in species of the animal affected, geographical
range, and other local conditions. He now agrees with the latter opinion. There are
some of the symptoms which I have observed as differing markedly from those mentioned in
the report on Surra. I have seen serous effusion beneath the vulval mucous membrane,
but very seldom the petechiæ in that situation as described by Dr. Evans; swelling of
the sheath in males and below the sternum in females was noted in Surra, but I find
Appendix, Disease Charts,
Natural cases
Artificial case
..
Record case book
entries.
Illustrative of diag-
nosis
..
A.
A. A.
XV
B. B.
B.
Total records of cases.
&c.
39
11
31
57
70
54
7
5