414 DISEASES OF UNCERTAIN ETIOLOGY 



SYMPTOMATOLOGY. 



It affects children of the rich and poor alike. 



The onset is rather sudden in the first year of life. 



Sallow tint of skin and irregular fever are present. 



The spleen enlarges much and is tender, hence the name " ponos " 

 = pain. 



Prostration is marked and emaciation progressive. 



Late in the disease oedema and ascites set in. 



Hcemorrhages from the gums and from other organs are not 

 uncommon. 



Bronchitis, pneumonia, dysentery, peritonitis and meningitis are 

 complications to be looked for. 



The disease lasts from two months to two years. 



A pronounced leucopenia has been found. 



Some suggest because of this that it may be of protozoal origin, 

 related to kala-azar. 



TREATMENT. 



Nothing specific is known. 



TROPICAL LIVER. 



A condition of hepatic congestion brought about during the first 

 two years' residence of Europeans in the Tropics. 



Chills, changes and excesses of food and drink cause hypera^mia 

 of the liver, congestion, blood stasis and diminution of the function 

 of that organ. 



SYMPTOMATOLOGY. 



There is frontal headache, malaise, nausea, dyspepsia, constipation 

 and pale-coloured stools. 



The liver is slightly enlarged and tender, slight icterus, diminished 

 urine, irritability, slight fever to ioo° F. 



TREATMENT. 

 Rest in bed in acute cases. 

 Calomel, 2 grains, followed by saline purges. 

 Hot fomentations to liver region are good. 



Bland diet, no alcohol or spiced foods, moderate exercise, avoid 

 chills. 



The following mixture has been found useful : — 



H Ammon. carb. ... ... grains 2-5 



Sod. bicarb. ... ... ... ... ... ,, 20 



Citr c acid „ 20 



One ounce thrice daily. 



