able, therefore, that the same, or a similar, fever occurs in many other parts of the world, haring been confounded hitherto with malarial fever or with typhoid. This conviction is based rather on clinical than on laboratory observation.
As it is extremely prevalent at times in the Mediterranean fleet and in the garrisons of Gibraltar and Malta, this disease is specially interesting to naval and military surgeons. Although only occasionally proving fatal, it is a fruitful source of inefficiency and invaliding.
Until recently it appeared to be on the increase in its old haunts, and to be becoming common in places where it was formerly rare Port Said and Egypt, for example.
The following figures, supplied by Bassett-Smith, show its importance formerly to our Naval and Military Services in the Mediterranean:—
INCIDENCE OF UNDULANT FEVER
| ARMY | ARMY | ARMY | NAVY | NAVY | NAVY | Total days | |
| Year. | Strength | Cases. | Deaths. | Strength. | Cases. | Deaths. | sickness. |
| 1900 | 9,203 | 171 | 10 | 14,250 | 356 | 6 | 22,998 |
| 1901 | 9,384 | 288 | 10 | 14,070 | 286 | 3 | 16,987 |
| 1902 | 10,889 | 198 | 10 | 18,470 | 436 | 3 | 27,432 |
| 1903 | 10,608 | 507 | 11 | 18,410 | 400 | 6 | 30,541 |
| 1904 | 10,615 | 429 | 15 | 19,590 | 430 | 9 | 28,458 |
History.— Formerly undulant fever was confounded with typhoid and malaria. The labours of clinical observers from Marston (1861) to Maclean (1885), and more especially the bacteriological researches of Bruce (1887), Hughes, Gipps, Wright, Semple, and Bassett-Smith, have established it as a special disease. More recently an important advance of great practical value has been made by a Royal Society Commission, which has shown that the germ of this fever infests several of the lower animals, especially goats, in whose milk and urine it is excreted.
trustworthy. (This was written before the discovery of M. paramelitensis; it may be that the appropriate test was made with the wrong strain of micrococcus, and hence the discrepancy in the results. ) Lately, complement-fixation tests have given good results in Bassett-Smith's hands.
