History and Geographical Distribution
History.—It is generally considered that a disease described by Hippocrates, in which there was an irregular febrile course without crisis but showing relapses and running a very prolonged course, was probably Malta fever.
In 1861 Marston showed on clinical and pathological grounds that the disease was different from typhoid fever.
In 1887, Colonel Bruce isolated the causative organism from the spleen at autopsy and established the demands of Koch’s postulates by reproducing the disease in monkeys with cultures from the spleen and then recovering the organism from the monkeys.
Our present accurate knowledge of the epidemiology of Malta fever and its connection with the use of the milk of goats is due to the work of a Commission appointed to investigate the disease—1904 to 1907.
Fig. 74.—Geographical distribution of Malta fever.
Geographical Distribution.—It is usual to consider Malta as the focus of the disease, with the cities of the Mediterranean shores showing quite a degree of infection. It is probable that the spread of the disease has been in part connected with the importation of Maltese goats, these animals being desirable on account of their superior yield of milk. It is now known that outside of the Mediterranean basin the disease exists in India, East and South Africa as well as Northern Africa, China, North and South America and the West Indies.
Mohler has shown that the disease under the names of “slow fever” and “mountain fever” has existed in Texas and New Mexico for at least twenty-five years.