394 DISEASES OF UNCERTAIN ETIOLOGY 



O pium poisoning. 



U raemic conditions. 



D iabetic conditions. 



T ropical diseases, malaria, sleeping sickness, &c. 



TREATMENT. 



Remove the patient to a cool place and loosen clothing. 



Application of cold water and cold sponging. 



Ice is essential for hyperpyrexia. 



Put the patient upon a rubber stretcher covered with a sheet and 

 the head raised, a sheet also covering the patient. 



Place ice on sheet for two minutes and put the patient between 

 blankets in bed. 



Give tincture of digitalis, 30 minims. 



If the patient is plethoric, bleed from the median basilic vein. 



Cease treatment when the temperature is down to 102*^, 103° F. in 

 the rectum. 



Later apply hot bottles and stimulants. 



Avoid strychnine as convulsions are not uncommon. 



Artificial respiration may be necessary for an hour or longer. 



Antipyretics are dangerous. 



Relapses are common. 



Salines and bromides may be useful. 



Urge total abstinence. 



Blue glasses and helmets should always be worn afterwards. 



Spinal pads and neck shields are preventive measures. 



SOME UNCLASSIFIED FEVERS. 



(1) JAPANESE RIYER FEVER (Tsutsugamushi Disease). 

 DEFINITION. 



An acute endemic febrile disorder caused by the bite of the larval 

 form of the mite Leptus akamushi, associated with a small local 

 necrotic area, enlarged proximal glands, and an exanthematous 

 eruption. 



DISTRIBUTION. 



The Island of Nippon (Japan), in the Akita and Xugata districts. 



The causative mite appears in the areas flooded bv rivers a few 

 weeks after the waters have subsided. Because of them the districts 

 have been almost abandoned. 



iETIOLOGY. 



This is unknown. 



Bacterial, protozoal and chemical theories have been advanced. 



