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XXIII] by an initial pyrexial stage of from ten days' to a fortnight's duration, followed by a stage of from three to seven days' relative or absolute apyrexia, which, in its turn, is succeeded by another spell of about ten days' duration of smart fever, and then by convalescence (see Chart 6). Both in the primary and the terminal fever the evening temperature may rise to 104° or 104.5° F. It might be said that such cases are relapses of simple continued fever; but as I have seen, on at least two occasions, the same succession of events occurring almost simultaneously in two patients living in the same house—once in husband and wife, and once in brother and sister—it seems probable that this is a special form of disease, and that the double fever is a constant and characteristic feature. In the case of the brother and sister the march of their fevers was strictly simultaneous, the primary

Chart 6.—Double continued fever, Hong Kong. o indicates a dose of antipyrin.