secure treatment before this time, he should take a single dose of
twenty grains of quinine.
To children may be given a daily amount of quinine equal to one grain
for each year of their age. In the severe forms of remittent and
pernicious types of malaria it may be necessary for the patient to
take as much as thirty grains of quinine every three days or so to cut
short the attack. But, unfortunately, the digestion may be so poor
that absorption of the drug does not occur, and in such an event the
use of quinine in the form of the bisulphate in thirty-grain doses,
with five grains of tartaric acid, will in some cases prove effective.
Chronic malaria is best treated with small doses of quinine, together
with arsenic and iron. A capsule containing two grains of quinine
sulphate, one-thirtieth grain of arsenious acid, and two grains of
reduced iron should be taken three times daily for several weeks.
=YELLOW FEVER.=--This is a disease of tropical and subtropical
countries characterized by fever, jaundice, and vomiting (in severe
cases vomiting of blood), caused by a special germ or parasite which
is communicated to man solely through the agency of the bites of a
special mosquito, _Stegomyia fasciata_.
=Distribution.=--Yellow fever has always been present in Havana, Rio,
Vera Cruz, and other Spanish-American seaports; also on the west coast
of Africa. It is frequently epidemic in the tropical ports of the
Atlantic in America and Africa, and there have been numerous epidemics
in the southern and occasional ones in the northern seacoast cities of
the United States. The last epidemic occurred in the South in 1899.
Rarely has the disease been introduced into Europe, and it has never
spread there except in Spanish ports. The disease is one requiring
warm weather, for a temperature under 75 deg. F. is unsuitable to the
growth of the special mosquito harboring the yellow-fever parasite. It
spreads in the crowded and unsanitary parts of seacoast cities, to
which it is brought on vessels by contaminated mosquitoes or
yellow-fever patients from the tropics. Havana has heretofore been the
source of infection for the United States, but since the disease has
been eradicated by the American army of occupation, that danger has
been removed. Yellow fever is not at all contagious in the sense that
a healthy person can contract the disease by contact with a
yellow-fever patient, or with his discharges from the stomach, bowels,
or elsewhere, and is probably only communicated to man by the bite of
a particular kind of mosquito harboring the yellow-fever organism in
its body. Both these facts have been incontestably proved,[12] in part
by brave volunteers from the United States Army who submitted to sleep
for twenty-one days on clothes soiled with discharges from patients
dying of yellow fever, and escaped the disease; and by others living
in uncontaminated surroundings who permitted themselves to be bitten
by infected mosquitoes and promptly developed yellow fever.
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