WITH MARKED PHYSICAL SIGNS 



1529 



5. Skin eruptions : — 



(a) Rose-red spots — Enteric fevers. 



(b) Flushing of the face, with subcuticular mottling and 



severe symptoms. Typical eruption on fourth day — 

 Typhus fever. 



(c) Purulent discharge from nose. Bullae, nodules, and 



ulcers in skin, with papulo-pustular eruption. 

 Work with horses — Glanders. 



(d) Pustular eruption — Glanders. 



(e) Dark or black pigmentation — Addison's disease. 



6. Enlarged lymphatic glands — Hodgkin's disease. 



7. Tenderness in a bone, especially near a joint. Blood 



cultures — Osteomyelitis. 



8. Nodules and tenderness in muscles. Puncture the nodules 



and examine : — 



(a) Vvis— Purulent myositis. 



(b) Filaria — Filariasis. 



9. Splenic enlargement 



Examine blood: — 



{a) ' Marked increase of lymphocytes or leucocytes with 



myelocytes^ — Leukmmia. 

 (IS) Malarial parasites or pigment in leucocytes — 



Malaria. 



Splenic or hepatic puncture : — 



[a] Malarial parasites or pigment — Malaria. 



iff) Leishmania parasites — Kala-azar. 



{c) Absence of Leishmania parasites — Splenomegaly, 



febrile form, 

 (d) Toxoplasma bodies present — Toxoplasmosis. 



B. WITHOUT MARKED PHYSICAL SIGNS. 



Intermittent fevers : — . . 



I. Fever every third or fourth day — Malaria. 

 II. Fever every day. Examine blood: — 



1. Malarial parasites or distinct mononucleosis — Malaria. 



2. Malarial parasites absent; distinct polymorpholeuco- 



cytosis — -Septic fevers. 

 Relapsing fevers : — 



Fever for several days after period of apyrexia — Relapsing 

 fevers. 



Remittent and continuous fevers : — 



I. Benefited by quinine, with or without parasites in blood — 

 Malaria. 



