_Symptoms._—In very acute cases the onset may be very sudden, the patient rapidly losing consciousness. As a rule the disease begins with headache, stiffness of the neck and chilly sensations. There may be vomiting, and the temperature is raised. The mind is often confused, and the patient may be delirious. The skin eruption, which occurs especially on the back and about the joints, and which is responsible for the name “spotted fever,” is not very frequently seen, and can hardly ever be detected on a dark skin. In very bad cases there is violent delirium, laboured breathing, and a purulent discharge from the nostrils. One of the most characteristic features is retraction of the head, while a dislike to light is common. _Prophylaxis._—Avoid unnecessary fatigue and guard against overcrowding, faulty conditions of ventilation and those which tend to cause naso-pharyngeal catarrh. Persons who have been in contact with cases of the disease are probably well advised to wash out their noses with a dilute solution of permanganate of potash 1 in 1,000. _Treatment._—In the absence of a medical man this can merely be symptomatic. Hot baths relieve pain and restlessness. Ice to the head, antipyrin, caffeine or aspirin relieve headache, and sedatives may be given for the insomnia and delirium. The patient’s mouth is foul, and should be carefully swabbed and kept clean. _Chicken-Pox._ In the tropics this disease is very largely one of adults. Incubation period, a fortnight to three weeks. Rash appears first day. _Rash._—Pink spots, upon which blebs form after twelve to twenty-four hours. The blebs are at first transparent, but subsequently become yellowish, and after two to three days shrivel and separate, leaving a pink scar. The symptoms are usually very mild, perhaps only slight fever, and possibly headache. The appearance of the rash is often the first symptom. _Treatment._—Isolation, and light diet. Bed may not be necessary. _Chilblains and Frostbite._ Chilblains are usually found on the fingers or toes—after exposure to severe cold—especially when tight gloves or boots have been worn. Certainly the best way to promote the formation of chilblains is to toast the semi-frozen fingers or toes at a fire or stove, before the circulation has been re-established. When chilblains are threatened, the part should be well rubbed with snow, or with camphorated spirit. Sponging with hot vinegar is very effective. Chilblains are checked in the early stages by painting with tincture of iodine. Once they have developed a preparation containing carbolic acid is useful in allaying pain and causing them to disappear. Ulcerated chilblains should be dressed with boric ointment spread on lint. Prolonged exposure to intense cold leads to development of frostbite. If the case is a bad one, or injudiciously treated, gangrene or death of the part always follows; if this is extensive, amputation may be necessary.