Infectious ieterus studied in 96 eases observed in children from one to thirteen years of age. The onset was sometimes insidious, but usually was sudden and accompanied by fever, headache, and chills. Jaundice appeared ordinarily on the third or fourth day, sometimes at the end of a week. The urine became highly colored; the stools, pale. In only 3 eases did the urine contain a small amount of albumin. The liver and spleen were ordinarily increased in vol ume and were painful to pressure. Slow ing of the pike WaS noted in only 3 cases. Temperature was usually elevated during the first three or four days. The duration was three or four weeks. Of the 96 eases, G died, all of them with symptoms of choliemia. Kissel (Jahr buch f. Kinderheilk., B. 4S, S. 235, '99).
TWO clear eases of Weirs disease in both of which the NVidal reaction WaS positive even in RS strong a dilution as 1 to 1000. The reaction is often positive in jaundice from any canse; it does not seem to be the bile alone, bllt SOIlle com bination of the bile with the blood whieh is able to produce agglutination. Yet this does not explain these two ca.ses, for the reaction was much too strong to be referred to the icterns alone and was still pre.sent when this had already disappeared in almost the same strength. Though the presence of jaundice and nephritis, such as occurs invariably in Weil's disease, strongly militates against the diagnosis of ty phoid, yet the author is inclined to re gard the disease merely as a peculiar. abortive type. T. Eckardt (A1tinchener med. Wochen., July S, 1902).
Convalescence is usually uninter rupted, but in a certain number—about one-fourth—the fever recurs within a week, lasting five or six days, in only a few cases being accompanied by recur rence of jaundice, swelling of the liver and spleen, and alburninuria.
Convalescence is always slow, the strength not being restored for many weeks.
Of the symptoms, the most marked usually are the muscular pains, especially in the calves of the legs. The pains may be so severe as to obscure the other symp toms. They are much increased by movement and by pressure of thc muscles.
Etiology,--It is met with usually among males between the ages of fifteen and thirty years, but has been seen in children as young as eight. It occurs usually in endemic outbreaks in summer, affecting chiefly workmen engaged in in sanitary occupations or environments. It is rare in America. It doubtless be longs to the group of toxcemic jaundice, but as to the nature of the infection, whether specific or multiple. is still to be determined. In two out of three fatal cases Jaeger found a bacillus of definite characters in the organs of the body, and in the urine of four out of six cases that recovered, the same organism was found. Ducks and geese—frequenting the river in which these cases were supposed to have acquired the disease by bathing— were subject to a fatal form of jaundice, and in them similar post-mortem changes and the same organism were found.
Grotip of eases of epidemic jaundice, eleven in number, which occurred in five families living in Parkhead, Glasgow. Russell (Brit. Med. Jour., Aug. 11, 'SS).
Infectious ieterus is a general acute speeifie-infectious, miasmatic, non-eon tagious disease. It may be sporadic, epi demic or endemic, and, as a rule, ruin ft favorable course. It stands. in some way, in a certain relation to typhoid fever and to typhus biliosus. The infectious agent arises outside of the human body. '1'he disease never relapses. Ilennig (Volk mann's Sammlung klin. No. S. '90).
Case showing analogy between AVeil's disease due to proteus and ieterus neorm tortim. Bar and Rimon (Comptes lien diis llehd. des Si,anees, etc., .May 24, '95).
Infectious ictertis due to a proteus in fection. Doribts concerning Banti's now bacillus. jaeger (Deutsche med. 'Woe1)., Oct. 3, '95).
Experimental study of Neil's disease, or acute infectious jamnliee. Very few eases have been recorded in Amcrica, probably because the meat-supply is good. 'The sonree of the infective agent is almost certainly putrid or decompos ing meat, or water tainted thereby. From a fatal ease the writer isolated a bacillus closely allied to, Mit not abso lutely identical with, the bacillus pro tens found by -Iiiger in cases of Weil's I, 1... 1 tt Mien itt ,. s• • Ira, guinea pig-, or et t I t a• me palt•11011!.11111tOtIA .1,6. 41.1111,1 ,•f It\ er and kidneys.
11 t et up Jaundice, Ills ex no.tin.- to. I • At out t lw obscreit• •• t it the I ,t, tound in the - o -in ill number. or not at :In.
.11%-oluill.lt loll 1:11o, p1.100 i'llb.t1) by I . 11/1:111, .111,1 111:11 11 is excreted the urine. The di.ea-c elosely re . • s form. of ? ellow fever, and i- •-.il le that the di.ease. are really ,•1.e. au I that the modifications in fre 1,1,1, ,atitr.e. and ,eterity are largely t o Altered dietetio and climatic con ',it'', Harlow Brooks (Archives of '‘,111-,,L and ehopath.. oct., loot).
ItIorbid Anatomy.—The liver-changes as(mble those found in acute yellow atrophy, but to a much less degree. There is. fatty degeneration and cloudy swelling of the renal epithelium, or even an acute parenchymatous nephritis. .Minute hmmorrliage exist in various rgans and on the serous surfaces. The spleen is swelled. There are no traces of typhoid ulceration.
Wc-irs disease in which the I -t 11,ttem showed bilateral hwinor rl agi nephritis, wdema of the lungs, :it'd by' cricinia of the mucous membranes in g•tioral. The liver was a , i.11-1roNt n color. was not enlarged, and erntainel a moderate amount of fat. W.
r Dent. med. Woch., Oct. 26, '99).
Prognosis.—()Lly a small number of cas_s I are terminated fatally, but eon v... -ecLee is protracted.
Treatment.—This is quite symptom a-re. The pa:ns will require anodyne for e'r relief.