10
17th November 1884) and from time to time fresh cases occurred—nine in number ;
thus I have had in all 17 cases for study of the disease as occurring naturally. The
needs of the inquiry have compelled me to induce the disease artificially in other
patients of various species and in different ways. The disease invariably proved fatal,
so that I had an opportunity of making a large number of post-mortem examinations
illustrating both complicated and uncomplicated cases of the disease. I have appended
an account of my methods of inquiry and record, together with a summary of diary
of work done. I trust that the facts ascertained, the observations made, and the
conclusions arrived at by me will be considered satisfactory ; they seem to me to very
materially add to our knowledge of the disorder, as was to be anticipated from the
exceptional facilities which have been afforded me in the inquiry, and from Dr. Evans'
" Report on ' Surra' in the Dera Ismael Khan District, 1880," constituting an excellent
basis of work, once I had proved to my own satisfaction that I was dealing with either
Surra itself or a very closely-allied disorder. I trust that this report will, in its turn,
be found a stepping stone to further advances in our knowledge of relapsing fever in
quadrupeds and even in man, and that such matters as I have not been able to settle
will, by having attention drawn to them herein, be indirectly ascertained through its
agency. The disease in question is inferior to none in pathological interest and
complexity, and it promises to assume enormous importance in the future on account
of its fatality, the number of species to which it is communicable, and the close
relations it bears to relapsing fever of man. Under these circumstances, it is well that
ab initio it should be the subject of careful inquiry, and I feel gratified in having been
one of the workers selected to make it known to science.
PART II.- THE OUTBREAKS.
1. For some time after its first appearance the disease with which I have been
dealing, and of which I have, in Part I, given the history, remained unrecognized as an
epizootic or enzootic. It was supposed that the fatal result depended on a different
pathological condition in almost every case. Veterinary Surgeon (First-class) Frost
soon corrected this error in Rangoon; but, until quite recently, it prevailed in Tonghoo,
where we find the following recorded as the supposed causes of death :—Congestion,
softening, or impairment of functions of the brain; fever ; old age ; debility ; imperfect
action of the heart ; blood-poisoning owing to imperfect action of the liver and kidneys;
acute nephritis ; impure condition of the blood ; congestion of brain, lungs, and liver ;
congestion of brain and lungs ; clot in right ventricle; peritonitis ; stomach eroded; dila-
tation of the heart ; inanition ; senile degeneration ; and so on. We have here a curious
indirect record of the conditions present after death in cases of relapsing fever, which,
with the symptoms and post-mortem appearances already noticed (in Part I, paragraphs
4 and 5), amply confirms my opinion of the nature of the disease causing fatality at
Tonghoo. It is necessary for me to summon all my evidence on this point in order to
carry as thorough conviction on it to the minds of others as there is in my own,
especially since Inspecting Veterinary Surgeon Evans, in his visit to Tonghoo, arrived
only at doubtful opinions on this point, and, indeed, his views tended to negative mine
somewhat. But, if I understand his views rightly, he is not prepared to oppose negative
results obtained from a necessarily hurried inquiry to my positive results in the same
direction. I selected a number of animals considered by the Transport Officers to be
affected with " the disease," and proved its existence by demonstration of the parasites
in a large proportion of these cases. Dr. Evans selected thirteen animals for destruc-
tion (which were not considered by the Transport Officer as affected) on account of
excessive debility; he examined their blood only on one occasion and found parasites
then present in the blood of only one case. Although these animals were not neces-
sarily affected with the fever, being selected merely as being the poorest-looking mules
of the infantry at Tonghoo, there is no doubt in my mind that the proportion of affected
animals among them was higher than the results of Dr. Evans' blood examinations
would appear to indicate : firstly, they seem to have all been thought free from fever,
i.e., any actually affected were in that stage of the disorder when the parasites are, as