1532 



THE DIAGNOSIS OF A TROPICAL FEVER 



{e) Intestinal indigestion a marked feature : — 



I. Examine motions after test-meal for muscle 

 fibres, fat globules; extract fat. Examine urine 

 for Cammidge's reaction. Fever not a marked 

 symptom — Chronic pancreatitis. 

 II. Attacks of fever a marked symptom. No muscle 

 fibres, etc., in motions. No Cammidge's urin- 

 ary reaction. Examine fseces after a purge for 

 eggs of intestinal worms, and if absent, for 

 micro-organisms of proteus and allied groups — 

 Intestinal infections and ioxcemias in helmin- 

 thiasis. 



(/) Enlarged lymphatic glands a marked feature — 



I. Fever not a marked feature; glands very much 



enlarged in many parts of the body. No very 

 great increase in the number of leucocytes — 

 Hodgkin's disease. 



II. Attacks of fever a marked feature. Glands only 



moderately enlarged, especially in the posterior 

 triangles of the neck. Residence in Tropical 

 Africa. Examine gland juice for trypanosomes 

 — Sleeping sickness. 



Summary. 



This small sketch of the diagnosis of certain tropical fevers may 

 be found useful when read in conjunction with the preceding 

 chapters. We would, however, again emphasize the point that 

 the only method of diagnosing fevers is by long bedside experience, 

 associated with careful laboratory work. 



