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being freely taken ; slight epistaxs; a restful disposition and ability 
to sleep, and fever from 102 0 to 103-5° or w 4 ° F. (38-9° to 39-7° or 
40° C.) with gradual defervescence by the third day. 
A fair prognosis is a drier skin ; 600 grammes of urine, albumin 
increasing but not exceeding 2‘o to 3'0 grammes per litre; light 
jaundice; slight attacks of black vomit which occur on the fifth day, or 
glosso-labial haemorrhages. 
A serious prognosis is a dry skin ; high fever of 103-5° t° I0 4 ‘ 4 ° F. 
(39 0 to 40-2° C.) for two or more days ; considerable gastric disturb¬ 
ance from the onset ; early appearance of albumin which, although 
in small amount, is associated with a diminution in the quantity of 
urine, 400 to 600 grames ; much jaundice ; hiccough, fairly copious 
black vomit ; epistaxis, glosso-labial haemorrhages ; tendency to 
become delirious ; feeble and thready pulse. 
A very grave prognosis is the above with greater tendency to 
copious black vomit and haemorrhages; hiccough constantly recur¬ 
ring; violent delirium ; pronounced icterus and failing renal system ; 
symptoms of collapse and subnormal temperature, or a history of 
temperature falling on the third or fourth day and followed by a sudden 
rise to 104° F. (40° C.) with complications such as abscesses of the 
parotids or pneumonia. 
MANAGEMENT AND TREATMENT 
The most important points in the management of yellow fever 
cases are nursing, absolute rest in bed, restriction of all nourishment 
for the first few days, the use of alkaline waters and the cautious 
administration of drugs. You must make yourselves responsible for 
the entire management of the case, and should: 
1. Obtain as full a history of the onset as possible, and of the 
Patient’s habits, temperament, etc. 
2. Examine your patient thoroughly, and do not postpone the 
examination. Yellow fever is a disease which runs too rapid a course 
to P e rmit of any delay. 
3 - Examine a fresh specimen of urine. If , vou h ave ^ ee 
summoned within the first twenty-four hours it will probably contain 
albumin. Give orders to preserve all the urine passed by the 
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