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December 11, 1937


Author Affiliations


From the Departments of Medicine and Clinical Laboratories, the Geo. F. Geisinger Memorial Hospital.

JAMA. 1937;109(24):1966-1971. doi:10.1001/jama.1937.02780500022008

The purpose of this paper is to discuss briefly the diagnosis and treatment of undulant fever. Time does not permit a full review of all the therapeutic measures which have been offered; therefore our remarks will be limited mainly to a further discussion of the use of intravenous injection of killed typhoid and paratyphoid organisms in the treatment of this disease.

The diagnosis of undulant fever is dependent on the laboratory for final confirmation. In this connection certain diagnostic problems confront the physician. The patient may present some of or all the classic symptoms, namely, irregular fever, profuse night sweats, weakness, nervousness, epigastric pain, nausea, vomiting, arthralgia and, in addition, some complication, such as involvement of the central or the peripheral nervous system or suppurative arthritis, and yet the blood may show no agglutination for organisms of the brucella group. This negative reaction may be due to the insufficient lapse