Relapsing Fever in Seistan

To the Editor of "The Indian Medical Gazette." Sir,?During the period February to May of this j'ear 4cases of relapsing fever were admitted to the Seistan Consulate Hospital. Diagnosis was confirmed by microscopic examination of the blood. The clinical description conformed closely to that of the Indian variety of the disease. One patient, however, a strong healthy man 28 years of age, developed a mild attack of mania after the crisis of the first period of pyrexia. This continued during the npyretic interval, disappeared on the supervention of the first (and only) relapse, reappeared at the second crisis, and continued for 5 or 6 days : he then made an uninterrupted recovery. All the patients?wifli one exception?w^re healthy men between the ages of 20 and 3d. The exception was a man of 45? but otherwise in robust health?an ex-havildar of the Indian army. This man got a severe attack of the disease and died at the crisis, of heart failure. All the others recovered. The spirochetes appeared to me, and to a colleague who examined many of the specimens with me, to be identical morphologically with that found in the Indian type of relapsing fever. I am informed by a colleagu" that no case of the disease has been seen on the Nushki-Seistan road. None of my patients were Afghans. The disease was also prevalent in the villages of Seistan. It would appear, therefore, to have arisen in Persia, and not to have been imported from India or Afghanistan. I regret that other'pre-occupations prevented me from investigating the means by which the disease was spread, with such thoroughness as to make my observation on this question of much value. I think, however, I may say that