54
General observations, work done, &c.—Post-mortem examination of No. 15 (D 181). The
only ordinary appearances of relapsing fever were olots in the large vessels, the heart fat.
gelatinous, its muscular substance fatty, slight fluid in chest Froth in trachea, some lesions of
the lining membrane of the stomach obscured by the effects of the irritant and chemical action of
the ammonia used in treatment which were marked on stomach, oesophagus, and bowels. Lungs
activelly inflamed. Kidneys and brain (with its membranes) congested.
My methods of inquiry into causes are explained in the text. All data are from the Returns
in the British Burma Gazette, which I collected, tabulated, and drew up in the form of Graphic
Records. A certain amount of literary work, apart from the actual drawing up of the report, has
been carried out. This consisted in digestion and precis of various Government records,
researches as to the literature of the subject and possible solutions of the problem as to the nature
of the disease in periodicals and text-books—medical and veterinary. 1 am much indebted to
Mr. Frost for (in addition to the numerous other ways in which he assisted me in my work at
Rangoon) placing his library at my disposal. I claim for my exact record of the influence of
physical and climatic causes on the production of the disease a sound practical value. The
tendency in study of diseases due to micro-organism seems to be to allow such causes to be
obscured by attention to the vital conditions of " the parasite. I have tried to apply the older,
practical, and the more recent biological methods to the investigation of etiology of equine
relapsing fever.
The post-mortem examinations were all made as soon after death as practicable. The
ordinary routine was adopted. Abnormal parts were placed at once into Muller's or Goulard's
fluids, or into solutions of spirit, or else examined immediately under the microscope. Such
rough semi-diagramatic illustrations of the conditions found as I was competent to make were
carried out for illustration of the report. The principal fluids and tissues examined microscopi-
cally were as follow:—Blood, urine, abdominal and thoracic serum, lymph from various parts
of the body, spleen pulp, heart muscle, gastric walls, conjunctival petechise, abdominal contents,
lymphatic gland, kidney. The results will be found embodied in the report.
Such portions of the carcasses as were not consumed by vultures (among which animals no
special fatality was observed in consequence) were carefully consumed by fire. The place of
post-mortem examination was carefully disinfected and cleaned.
All observations made in the sick lines were entered in a register and record case book in
the usual official manner. From the records a thermographic chart (giving full details of the
case) was prepared. From each individual case pathological deductions were obtained and
recorded. Many a result casually mentioned in the body of the report represents a week's
careful work.
My clinical observations were carried out by me in full detail for the first month of the
inquiry ; subsequently, except during my absence at out-stations, the records were every morning
made under my personal supervision; generally also in the evening I attended to make observa-
tions and supervise. This discipline was relaxed somewhat towards the last when the main
facts had been ascertained and special details had to be followed out. My assistants, as trained
by me, attained a very creditable amount of manipulative skill. All experimental cases were
treated clinically in the same way as natural cases. My subjects were several old and worn-out
mules, one pony, one bullock, one monkey, one dog, and one goat. The principal experiments
were —
Mules—(a) Twice administration of gastric contents from affected mule through the
mouth.
(b) Subcutaneous injection of blood of a mule in the active fever phase mixed
with water.
(c) Gastric ingestion of a considerable amount of similar blood.
(d) Inoculation with a mixture of water and virulent blood thoroughly dried.
(e) Inoculation with blood in which no parasites were detectable on micro-
scopical examination, but from an affected patient.
(f) Inoculation with blood from the heart of a recently dead patient taken
before coagulation.
(g) Inoculation with blood of a feverish animal drawn directly from the
jugular and at once thrown into the subcutaneous tissue.
Pony—(h) Transmission of disease by inoculation with blood of a feverish mule
(spirilloids present).
Bullock—(i) Unsuccessful inoculation with spirilloid containing blood from a mule (only
local lesions resulted twice).
(j) Unsuccessful injection of spirilloid containing blood into the peritoneal sac.
Goat—(k) Unsuccessful inoculation with spirilloid containing blood from a mule (twice).
(l) Injection of similar blood into the peritoneal sac ; result dubious.
Dog—(m) Inoculation by subcutaneous injection of spirilloid containing blood.
Monkey—(n) Inoculation by subcutaneous injection of spirilloid containing blood.
A number of minor experiments were performed.
I was enabled, from the Tonghoo Death Reports, to supplement my Rangoon records with
those of cases at Tonghoo.