YELLOW FEVER 365 



Wrrugas occurring in the larnyx cause dyspncea, 



bronchi cause bronchitis, 

 lungs cause pneumonia, 

 pleurae cause pleurisy, 

 nose cause epistaxis and occlusion, 

 oesophagus cause dysphagia, 

 intestines cause blood and diarrhoea. 

 ,, ,, meninges cause cerebral symptoms. 



,, ,, uterus cause metrorrhagia. 



In four to six months there are several crops each preceded by 

 attacks of fever. The eruption then disappears, nodules dry up without 

 scarring, ulcers cicatrize. The patient is convalescent but anaemic and 

 weak. The eosinophiles may disappear. 



ATYPICAL TYPE. 



Sometimes the eruption is less typical and somewhat localized or it 

 ma\' develop and disappear, the general symptoms returning later and 

 are then more serious. 



Some cases show but little fever. 



PROGNOSIS. 



An early general eruption is a good sign. 

 A mild eruption with ana?mia is bad. 

 Subcutaneous nodules with Carrion's fever, bad. 

 JNIortalitv 10 to 40 per cent. 



The disappearance of a poor eruption with a return of the fever and 

 the pains are bad. 



TREATMENT. 



There is nothing specific known. 



Remove the patient from the endemic area to warm country districts. 



Try arsenic, atoxyl, arsenobillon. 



Avoid chills and cold baths. 



Drugs are useless in the febrile stage. 



Give tonics during the convalescence. 



Treat Carrion's fever as typhoid. 



YELLOW FEVER. 

 DEFINITION. 



It is an acute specific, endemic and epidemic fever, characterized by 

 two paroxysms of fever separated by an intermission; albuminuria, 

 jaundice, black vomit and haemorrhage. 



The Stegomyia calopus carries the virus. 



DISTRIBUTION. 



Yellow fever is supposed to have attacked the troops of Columbus 



