1252 



DENGUE AND ALLIED FEVERS 



There are no complications or sequelae, and the prognosis is excellent, as 

 the mortality is nil. Mild recurrences in following years may be met ^^ith, 

 but relapses in the same year, though rare, do occur, as we have met with such 

 a case. Convalescence is rapid. 



Day Of 

 Illness 



■0?° 



00' 



99" 

 Normal \ 

 Tgmp L 

 of Boc^y } 



98" 



1 



2 



3 



4 



5 



6 



7 



M 



E 



M 



E 



M 



E 



M 



E 



M 



E 



M 



E 



M 



E 



























































































































































































































































































































































































































































































































































































































































































Fig. 633. — Temperature Chart of a Case of Seven Days' Fever. 



Diagnosis, — It can be distinguished from malaria by the absence of para- 

 sites, and the slow pulse with high fever; from influenza by the absence of 

 respiratory symptoms. 



Treatment. — This is purely symptomatic. 



DENGUE-LIKE FEVERS. 

 Synonym, — Climatic fevers. 



Under this heading come the fever of the Antilles, the fever of the Red Sea, 

 the six days' fever of Asia, the fever of Massowah, the six to eight days' fever 

 of Aden described by Smith and Loughman, the six days' fever of the Canal 

 zone in Panama described by Decks, and the pseudo-dengue fever of Cochin 

 China, which are all closely allied to dengue fever, lasting about seven days, and 

 being associated with pains in different parts of the body, and having, in brief, 

 the symptoms described above for seven days' fever or for dengue fever. 



VAN DER SCHEER'S FEVER, 



Synonym. — Five days' fever. 



Definition, — A fever usually lasting for five days, and associated with an' 

 eruption of red macules and papules about the size of a pin's head, occurring 

 on the trunk. It may be a form of dengue. 



Remarks. — This fever, first described by van der Scheer, has also been 

 investigated by Neeb, but its nature is at present not understood. 



Symptomatology, — The illness begins suddenly with severe headache and. 

 backache, the temperature rising to 104° to 105° F. in the evening, but re 

 mitting considerably in the morning. Sometimes there is bilious vomiting 

 and delirium. On the third day the eruption appears as macules or papules 

 about the size of a pin's head on the chest, which spread to the back and 

 abdomen. After five days' remittent fever the crisis comes on the sixth or 

 seventh day, when the temperature rapidly falls below normal. This fall is 

 accompanied by moderate sweating. In more severe cases the crisis is absent, 

 and, cardiac failure setting in, the patient dies cyanosed. 



