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CHAPTER XLIl 

 YELLOW FEVER 



Synonyms — History — Climatology — iEtiology — Pathology — Symptomatology 

 — Diagnosis — -Prognosis- — Treatment- — Prophylaxis — References . 



Synonyms.- — Bilious Remittent fever, Acclimatizing fever, Inflammatory 

 fever, Febris Flava, Pestis Americana, Typhus Icteroides. French : Fievre 

 Jaune. Italian : Febbre Gialla, Febbre Amarilla. German : Gelbfieber, In 

 addition, there are a large number of local names, such as Bulam fever 

 (Grenada) ; Kendal's disease (Barbados) ; Pest of Havana (Cuba) ; Maladie de 

 Siam (Martinique) ; Febre remittente biliosa dos bezos quentes (Brazil) ; Febre 

 amarelle dos acclimatados (Brazil); Magdalena fever (Columbia). 



Definition. — ^An acute specific non-contagious fever of unknown 

 causation characterized usually by two paroxysms of fever, separ- 

 ated by a remission or intermission, and accompanied with albumin- 

 uria, jaundice, and haemorrhages, with usually a normal number 

 of leucocytes and polymorphonuclear leucocytes. It is spread by 

 the agency of Stegomyia calopus Meigen, 1818 (synonym, 5. fasciata 

 Fabricius, 1805, non O. F. Miiller, 1764). 



History. — ^Yellow fever is believed to have originally been a 

 disease of the Antilles, and to have attacked the troops of Christopher 

 Columbus in 1495 in the Isle of Spain (St. Domingo), from which it 

 was carried by thje Spaniards to the mainland of America. The 

 endemic home of the disease at the present time is the east coast 

 of Mexico, where it was reported in 1509 at Vera Cruz, and Central 

 America from Cape Tampies to Cape Gracias a Dios, and the Greater 

 and Lesser Antilles. From this area it can spread by ships to various 

 parts of the world, where it may become epidemic. 



The first clearly written description of yellow fever is that by 

 P. du Tertre, in Guadeloupe, in 1635, but it soon became well 

 known from the epidemic in Cuba in 1648-49 ; Jamaica, 1655 ; 

 San Domingo, 1656; Martinique, 1688; and Vera Cruz, 1690. In 

 1698 it was recognized that the disease was being carried from place 

 to place by ships, and a quarantine ordinance was brought into 

 force, which lasted from 1709 till 1790, when the extensive wars 

 of the period caused it to be ineffective, with the result that between 

 1791 and 1815 most extensive epidemics took place, and gave 

 ample opportunity for the study of the disease. In 1794 Drysdale, 

 of Baltimore, in 1797 and 1805 Rush, in Philadelphia, and in 1802 

 Vaughan, in Wilmington, drew attention to the large numbers of 

 mosquitoes and other insects which abounded in their respective 



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