1462 THE UNCLASSIFIED FEVERS OF THE TROPICS 



ROBLES' FEVER. 



A peculiar form of continued fever, which is said not to be typhoid 

 and not to be malaria, is described by Robles, of Quezaltenango, and 

 Gann, of British Honduras. 



Robles has separated from the blood of the patients a micro- 

 coccus resembling Micrococcus melitensis, but liquefying gelatine. 

 The patients, who are usually derived from the younger members 

 of the poorer classes, are anaemic and debilitated, and live under 

 insanitary conditions. The fever is very irregular, being at first 

 remittent, but becoming intermittent, while the periods of apyrexia 

 increase in length and frequency as the disease progresses. The 

 symptoms are but slight, consisting of headache, malaise, furred 

 tongue, thirst, and anaemia, with slight constipation. The spleen 

 is either not enlarged or but shghtly so, while the liver is a little 

 tender on firm pressure. The duration of the disease is from two 

 to three weeks to several months. Convalescence is long drawn 

 out, there being much debility and disinclination for mental or 

 physical exertion. The prognosis is good, as recovery is the rule. 

 The best treatment is change to a cooler climate, good sanitation, 

 a light, nourishing diet, and a tonic of iron and strychnine. 



FORREST'S FEVER. 



Forrest has described a fever in Rangoon which he called ' Rangoon 

 local fever,' which lasts three to fifteen days, and shows a tem- 

 perature curve resembling a parabola, ascending and descending 

 gradually. The maximum temperature is 104° F., and the blood 

 shows a polymorphonuclear leucocytosis. 



NAEGELE'S URTICARIAL FEVER. 



Naegele described this in 1912 as occurring in South-West Africa. 

 It consists of fever associated with an urticarial eruption, affecting 

 the skin and mucosae, and associated with marked nervous symptoms, 

 loss of muscular power, neuritis, pains in the joints, affections of 

 the glands. When the wheals disappear the skin exfoliates. 

 Relapses are frequent. Bassett-Smith has suggested that it may be 

 due to some food toxin. 



HYPERPYREXIAL FEVER. 



Remarks. — ^There is a peculiar form of fever which we met with 

 on the Gold Coast and in Ceylon, and which was first described 

 by Thompstone and Bennett in Southern Nigeria. 



Climatology. — It is known to occur on the West Coast of Africa 

 and in Ceylon. 



etiology. — ^The causation is entirely unknown, but peculiar 

 bodies (Fig. 675) have been seen in smears from the spleen. We 

 are inclined to consider them contaminations. 



