VELLOJV FEJ^ER 



369 



SYMPTOMATOLOGY. 



Incuhiitiou . — Two to seven days. 



Prodrnniiitit usualU' absent. JMalaise may be present for several 

 days. 



The First Fever. — This comes on the first or second day, severe 

 frontal headache, sometimes rigors, pain in back and Hmbs, face and 

 skin flushed, eyes injected and painful, temperature rises rapidly to 

 103° F. or higher, respirations quick and laboured, pulse increases 

 from 100 to 120, full and bounding. \"omiting with epigastric pain, 

 constipation, urine diminished with high specific gravit_y, acid re- 

 action, albuminuria on second day, insomnia. 



Yellow fever. Severe attack. 



The Crisis. — This occurs about the end of the second day. The 

 temperature falls suddenly to normal or subnormal with sweating, the 

 pain and the flush both disappear, the patient feels better and sleeps 

 well. The urine increases. A mild abortive case mav recover at 

 this stage. 



The Second Fever. — This occurs on the second to the fourth dav. 

 A few hours after the temperature has fallen to its lowest and the crisis 

 has taken place the temperature begins to rise again steadily until it 

 reaches 104° or 105° F. But the pulse decreases to sixty or fortv beats 

 per minute (Faget's sign). The skin becomes jaundiced, and it 

 deepens with the days. The vomiting and the epigastric pains return 

 with thirst and prostration. Tongue dry, furred with red tip and 

 edges. Haemorrhages everywhere, vomit black, mal^ena, epistaxis,. 

 subcutaneously, from the mouth, &c. The urine diminishes, albumin 

 increases. There may be anuria. Restlessness and delirium are often 

 present. 



The Termination. — If recovery, then, after about four days, the 

 temperature declines, sweating commences, more urine is passed, 

 albumin diminishes, vomiting ceases, sleep is usual, and convalescence 

 sets in. 



