should be taken to avoid insect bites and other skin lesions. Laboratory workers must be careful in handling cultures of the micrococcus; the accidental introduction of the micrococcus into the conjunctival sac has sufficed to cause the disease.
When the diagnosis is sure, it is well to 'give a purge— none better than calomel and jalap— and to instruct the attendants to keep the patient's temperature systematically below 103° F. by cold sponging with vinegar and water or, if necessary, by cold bath or ice variously applied. In view of the prolonged nature of the fever, this measure is one of importance; at the same time, such treatment need not be applied too energetically, or so as to depress; a fall of 2° or 3° is all that is desirable.
Bassett-Smith recommends yeast and its products. Quinine and, on account of the joint affection, the salicylates are very generally prescribed. Both are useless, if not injurious. Phenacetin and similar antipyretics are also often given to bring down temperature; but the wisdom of employing depressing drugs in so chronic and asthenic a disease as undulant fever is, to say the least, questionable. Any threat of hyperpyrexia is best met as directed, namely, by early employment of sponging, the wet pack, or, if necessary, by the cold bath. Sleeplessness may demand hypnotics; headache, if severe, moderate doses of phenacetin, pyramidon, or similar drug; inflamed joints or testes, the usual local applications; constipation, enemata or aperients. In fact, the treatment of undulant fever resolves itself into a treatment of symptoms.
The therapeutic employment of vaccines of dead M. melitensis, prepared and administered according to Wright's methods, has been favourably reported on by Reid. In Bassett- Smith's hands the results have not been so favourable. After a prolonged and very careful trial, the latter concludes that if used during the acute phases of the fever, so far from doing good, they act detrimentally, but that in chronic cases, with slight relapses and low temperatures,— by stimulating slightly the machinery of
