1466 THE UNCLASSIFIED FEVERS OF THE TROPICS 



The mortality is less than i per cent,, and an attack confers a slight immunity. 

 It is thought that it may be due to some insect on the cane. The dermatitis 

 often found in cane cutters is described in Chapter XCIV. on p. 2163. 



In 191 3 Clarke described this disease more fully, and in 191 4 Breinl, Priestley, 

 and Fielding gave a longer account. 



NASHA FEVER. 

 Synonyms. — Naki-a fever, Nakhra Jawhur. 



Remarks.— Under the above terms Fernandez, in 1894, described a fever 

 characterized by swelling of the nasal mucosa as occurring in Bengal. 



Climatology. — It is found mostly in the months of April to August, and is 

 rare in the cold weather. 



etiology. — The causation is unknown. 



Symptomatology. — The illness is ushered in by a chill associated with high 

 fever and hyperrcmia, with swelling of the mucosa of the nose, and pains in the 

 head, neck, shoulders, and small of the back. The face is flushed, the pupils 

 contracted, and there is an eruption of small papules, often accompanied by 

 bronchial symptoms. 



The fever, which is usually remittent in character, disappears in three to 

 five days, when the nasal swelling also subsides. 



Relapses may occur in one to four weeks, and sometimes a severe relapse 

 may end in deliriunl, coma, and death. 



Treatment. — A saline purgative and a mild diaphoretic are first adminis- 

 tered, and then the nose is sprayed with iced water two to three times a day, 

 or the congestion is relieved by pricking the mucous membrane. Tannin and 

 10 per cent, cocaine solution may also be applied to the nasal mucosa. 



TIENTSIN FEVER. 



A somewhat similar fever has been reported by A. C. Fox from 

 Tientsin, but in his cases the fever lasted from ten to fourteen days. 

 He thinks it may have been a paratyphoid infection. 



It is characterized by sudden onset, remittent fever for ten to 

 fourteen days, frontal headache, constipation, slow pulse. The 

 constitutional symptoms are slight, relapses are rare, and the 

 mortality is nil, while convalescence is rapid. It occurs in persons 

 inoculated against typhoid and having no malaria. It may be 

 enteroidea. 



WHITMORE'S FEVER. 

 Synonym. — Morphine injector's septicaemia. 



Whitmore, in 1915, has described several cases of a glanders-like 

 disease in Rangoon, characterized by intermittent fever, broncho- 

 pneumonic symptoms, and often multiple abscesses in various parts 

 of the body. The bacillus isolated seems to be very similar to 

 B. mallei. 



In 1915 Knapp came to the conclusion that this fevei might exist 

 in other parts of India, and showed that the disease is due to the 

 contamination of the hypodermic syringe. 



