Marris' Atropine Test in Typhoid Fever and Its Value

was performed at head-quarters on Ross Island, which only confirmed the diagnosis, and the value of this simple atropine test. A synopsis of a few cases may be of interest and these I briefly append below:? Case No. 1.?March 1924. Female aged 28. Vomiting, purging, severe vertigo, enlarged spleen and liver. Blood swarming with double malaria infection. Quinine injections intravenously did not control the fever, although the parasites disappeared. The tongue remained coated, expression dull, pulse not in proportion to temperature. Atropine test applied, result positive. Unfortunately in this case no other diagnostic test except clinical evidence was used, but this was undoubtedly a case of typho-malarial fever. Case No. 2.?No. 45142. May 1924. History of fever for a week. Tongue thickly coated, bowels bound. Spleen enlarged. Patient comes from a heavily infected mosquito area, no malaria parasites found however; liver slightly enlarged and tender. Lungs clear. Quinine did not control the fever, the expression became dull, and slight discomfort was felt in the right iliac fossa on palpation. Atropine test positive. Widal reaction para A. 1-40 + + +: 1-80+ + +: 1-160+ + + . In this case the pulse came steadily down from 112 to 88 in three hours when the atropine test was applied. Case No. 3.?No. 40095. May 1924. Fever for four days, slight rigor with each rise. Diarrhoea. Tongue thickly coated and dry, very offensive breath, spleen 2 in. below costal arch. Slight cough and a few rales in the upper lobes of the lungs heard on the back. Extreme restlessness, pain, discomfort and gurgling in the right iliac fossa. Temperature ranged between 102 and 103? and pulse between 100 and 104. Patient had from the onset the appearance of a man who was very ill. Atropine test positive. Widal reaction: B. typhosus, 1-80: + + + 1-160+ ++. This patient had haemorrhage from the bowel four times. At the time of writing, although he is convalescent and on a full diet with a liberal supply of extras, he is very emaciated, and oyly weighs 78 lbs. Case No. 4.?No. 39735. June 1924. Duration of fever ten days. Extreme apathy. Headache. Bowels markedly constipated. Tongue red at the edge and tip, centre thickly coated, and dry. Gurgling in the right iliac fossa but no pain or tenderness or discomfort. Spleen enlarged, increase in the large monos, 15 per cent.; no malarial parasites found, lymphocytes 34 per cent. Temperature resistant to quinine. Marris' test positive. Widal reaction Para A. 1-40 + + + : 1-80 + + +: 1-160 + + + : 1-320 +-]+ .