38 



REVIEW — TKOriCAL MEDICINE, ETC. 



Dengue — 



coniituud 



DENGUE FEVER 



* Terminal rash fading 



temperature normal. — Case 9 was a European. I believe all the other bloods were those of 

 natives ; Egyptians, Arabs or Sudanese. 



In every instance 400 cells were counted. Still, in the apparently undoubted dengue cases 

 (Nos. 4, 5 and 7), the results ajspear to confirm those of Stitt, though, as mentioned in my 

 original paper, it is very necessary that some kind of standard classification of leucocytes be 

 adopted whereby differential counts by various observers in all parts of the world may be 

 made strictly comparable. 



A paper by Saigh,i on dengue in Port Sudan, states that the cases there occurred chiefly 

 in houses infested by mosquitoes (species not stated), and that the fever reappeared when 

 there was an increase of mosquitoes in the town. Further, all persons living in the hospital 

 escaped infection, and the hospital was the only place free from mosquitoes. 



Phillips- in his Egyptian cases used aspirin for relieving pain, and found calcium chloride 

 useful in heemorrhagic and urticarial cases. 



Dhobie Itch. This does not appear to be very common, at least in the Northern 

 Sudan. The climate is probably too dry to favour the growth and proliferation of the germs. 

 In one case I found what I believed to be Microsporon miuntissimnm. Chrysophauic acid 

 ointment proved efficient. Glacial acetic acid has been recommended, and for natives strong 

 liniment of iodine is most serviceable. 



Diarrhoea. This is always an important question in the tropics owing to its relation 

 with dysentery and sprue, but the infantile form also merits attention. Eecently there has 

 been much work done on infantile diarrhoea. 



Hewletf states that the Bacillus dysenteriie is probably the etiological factor in various 

 forms of infantile and epidemic diarrhoja. He mentions that Miss Wollstein isolated this 

 organism in all (39 out of 114) cases of infantile diarrhcea where blood and mucous were 

 present. 



An article in the Lancet for September 17th, 1904, in dealing with errors of diet as a cause 

 of infantile diarrhoea, mentions the septic variety which may attack strong as well as weakly 

 subjects, and in whicli nervous collapse may continue after the diarrhoea ceases to be a cause 

 for anxiety. Nash,' while admitting that there may be some connection between sub-soil 

 temperature and the advent of epidemic diarrhcea, regards contamination of food by infected 

 dust, and especially infection-conveying flies, as the main cause of the disease. "The 

 essentials," he says, "for putting a stop to the great waste of infant life every summer are 



' Saigh, S. (November 1,5th, 1906), " Dengue in Port Sudan, Rod Sea Province." Journal of Tropical Medicine 

 and Hijgicm, p. 348, Vol. IX. 



^ Phillips, L. (December loth, 1906), " Dengue in Egypt." Juarnal of Tropical Medicine and Hygiene, 

 p. 373, Vol. IX. 



' Hewlett, R. T. (April, 1904), "Dysentery and Infantile Diarrhoea, the Etiology of." Journal of State 

 Medicine, p. 229, Vol. XII. 



* Nash, J. T. C. (September 24th, 1904), "Some Points in the Prevention of Epidemic Diarrhcea." Lancet, 

 p. 892. 



