Distribution of Tropical Diseases in Africa. 479 
15 gers. of quinine, half an ounce of sulphate of sodium, dilute 
sulphuric acid, and tincture of cardamons, at first. If after 
the first two days the temperature remains above 100° F., 
with the usual symptoms of yellow fever, he adds phosphoric 
acid largely diluted with water, every hour or two.  Dia- 
phoresis is induced by vapour baths; the diet consists of iced 
milk and beef broth in small quantities at frequent intervals. 
On the other hand, Sternberg recommends bicarbonate of 
soda 150 grs., bichlorate of mercury ;%;th gr., water 2 pints; 
an ounce and three-quarters to be given ice-cold every hour. 
This treatment is slightly modified by Mitchell, who increased 
the dose of the bicarbonate of soda to 4 drs., and the bi- 
chlorate to half a grain. When patients are thus treated 
from the first day, vomiting rarely occurs. Diuresis is well 
maintained. After the eighth or tenth day it is necessary to 
suspend the bicarbonate of soda and give stimulants, and to 
combat the adynamia and the hemorrhages, etc., with the 
customary measures. For the vomiting I believe turpentine 
is the best remedy; it may be administered either by the 
mouth or-by enemata, and the body may be rubbed with a 
mixture of turpentine and olive oil. If suppression of 
urine occurs, I know of no better treatment than to 
apply a digitalis leaf poultice to the loins, and to throw 
up the rectum a pint or more of ice-cold water at regular 
intervals. 
The discharges of the patient are best disinfected with 
either chloride of lime or perchloride of mercury. Bedding 
‘and clothing are best destroyed by fire. Hospital wards or 
the hold of a ship should be fumigated with nitrous acid for 
at least forty-eight hours, and then all the woodwork washed 
with chloride of lime. For disinfecting the bilge-water of 
ships, chlorate of lime must be employed. 
Typhoid Fever. 
I have only a few remarks to make on this subject. 
Typhoid fever certainly exists in Africa, and it is also certain 
that the death-rate is higher there than it is in more tem- 
perate zones. I hold the view that the disease is due to 
VOL. XII. 21 
