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81
The Bacteriological (Serum) Diagnosis of Enteric Fever.—The
value of this test was again manifested. Daring the year there were
12 completed cases of enteric fever, and all these gave a positive
serum reaction.
In one instance a nurse (E.R.), suffering from fever was admitted
with the following history:—She left Malta with her mistress who
was suffering from Malta fever, 011 July 2nd, and arrived in England
July 10th. After arrival in England, the mistress had a relapse and
E.R. was in attendance on her at intervals until August 1st., when
she failed, with symptoms which suggested enteric fever. On
admission it was found that E.R.'s symptoms were anomalous,
and a specimen of blood was therefore examined to see if it
would aggluntinate a culture of Micrococcus melitensis. This
was found to be the case, and the subsequent progress of the
patient quite confirmed the diagnosis of Malta fever. This is a
disease of which we had no previous experience, and it is not easy
to understand how the patient became infected. If she brought the
disease with her from Malta the infection is longer than is commonly
supposed, whilst if she acquired the disease from her mistress in
England personal infection must occur, though this has been though
to be impossible,