resistance they are of real value, and it is to this type of case that he now restricts their use. Sergent concludes that the practical value of serum-therapy and vaccination in undulant fever has not been demonstrated.
The diet at first should consist of milk (in Malta, boiled); later, of broths and eggs and, if necessary, stimulants. Solids must not be freely given during high fever or when the tongue is coated. If appetite is present ordinary simple food may be taken. Lemonade or lime juice should be given after a time; not merely as a pleasant, thirst- relieving beverage, but with a view to averting scurvy not at all an improbable complication if the diet is too restricted over a long period. Feeding must be conducted with the greatest circumspection, avoiding overfeeding on the one hand and a low monotonous diet on the other. The tongue and the appetite are the best guides.
Exercise, travelling, and anything that tends to induce fatigue are prone to provoke relapse if indulged in prematurely; but a couch or chair in the garden is to be encouraged, weather permitting. The patient should rest for at least three weeks after temperature has become normal.
Flannel clothing should be worn, and frequently changed if there is much sweating.
Change of climate is not so necessary as in malarial affections, seeing that the disease may persist in England, and that it may gradually wear out in the endemic localities. It is not desirable to move a patient when fever runs high, or when debility is very great, or when the cool and healthy season in the Mediterranean is at hand. It must be considered that at this time winter is approaching in England, with climatic conditions very unsuitable for a patient who has become anaemic and debilitated from a long course of fever; at this season he would do much better in a milder climate. When, however, the case occurs early in the summer, or runs over the winter, then, in order to avoid the heat of the Mediterranean, change to England, if feasible and if it can be comfortably effected, should be advised,
