256 PHLEBOTOMUS FEVER AND DENGtJE. For the Bibliography of Phlebotomus Fever, see the Yellow Fever Bureau Bulletin. 1912. Vol. 2. No. 1. pp. 116-120. And No. 2. p. 246. Also Trop. Dis. Bull. 1913. Vol. 1. No. 6. p. 341. And No. 10. p. 604. For a synopsis of the genus Phlebotomus, see Summers. Jour. London School of Trop. Med. 1913. April. Vol. 2. Part 2. pp. 104-116. For Indian species, see Brunetti. Fauna of British India— Diptera, Nematocera. 1912. pp. 199 -216. For an extended account of the history of Dengue, see Mahe. Dictionnaire Encyclopedique des Sciences Medicales. 1883. Tome 26. pp. 698-788.
Discussion.
Sir Havelock Charles : I think we have heard to-night a paper of extreme interest clinically. Most of the meetings of this Society have been bacteriological evenings. This evening is interesting to the sanitarian, and also to the bacteriologist, but especially to the man who stands by the bedside.
Our thanks are undoubtedly due to Lt.-Col. Birt for the very able paper he has given us. There is no doubt about it that he is of the opinion that dengue and phlebotomus fever are totally different diseases. Major Megaw holds a different view. Col. Birt did not traverse Major Megaw's report, as I hoped he would have done. There seem to be two schools in this ; the unity and the dualist. Col. Birt is a dualist. We shall see before the evening finishes, when light has been shed upon this a little more, what the opinion of the meeting is.
There is very great difficulty in differentiating these short fevers, especially from commencing malaria and enteric. If you are absolutely sure that it is a case of 7 -day fever, or a case of dengue, you can relieve the anxiety of the patient and his friends ; that is very valuable for the practitioner. Another point is the differential diagnosis of the 3-day fever, the 7 -day fever, and dengue from each other ; but as the treatment of all is the same, the diagnosis is more or less of academic interest. That is one way of looking at it, but I do not think it is a good way.
My own experience of these two diseases has been personal and painful. I have suffered in the Punjab from short fever, which was not malaria, and also from dengue in Calcutta. In the Philippine Islands we have heard that convalescence is rapid and uninterrupted, but I did
