Any unhealthy wound, &c., should receive attention, as it may be the source of the dis ease. Indeed anyone suffering from a wound, erysipelas, inflammation of bone, &c., seized with shivering and sweating, should lose no time in summoning a doctor.
It is of the utmost importance to observe that the poison of septicemia and pytemia may be carried from one person to another, especially in the hands, &c. Therefore the patient should be kept strictly clean, in a well-ventilated room; all discharges, as well as clothes, &c., stained with them, should be disinfected by a solution of chloride of lime, and the attendant's hands should be frequently washed in Condy's fluid and with carbolic soap.
Scurvy (Scorbutus) is a disease due to an altered condition of blood produced by the ab sence from the food of certain ingredients it ought to possess. What the exact ingredients are it is not easy to say. Sailors deprived of a proper quantity of vegetables in their diet, and living too exclusively on salt meat, are easy victims to the disease. It is not limited to sailors, however, for a scurvy condition may arise on laud among ill-fed persons in times of want, and it has broken out among armies in the field. (Refer to VITAMINES, VOL II., p. 141).
Its symptoms are a pale, sallow, or muddy complexion, disinclination to exertion, and low ness of spirits. There are rheumatic pains in the back and limbs. The appetite is not af fected, but the bowels are bound. The tongue is large and flabby. In fact these preliminary symptoms are similar to those of amemia, al ready described. Characteristic signs of the disease soon appear, such as reddish-brown spots on the skin, first of the legs, then on the rest of the body. They are like flea-bites, and are, indeed, produced by the escape of small quantities of blood from small vessels. Petechim is the term applied to them. Blood may escape in large quantity, and give the appearances of a discoloration due to bruises. Puffy swellings also occur, specially about the elbows, knees, lower parts of the leg, the the jaws, and about the eyes. The gums swell, become spongy, deep-red in colour, and are easily made to bleed and ulcerate. The breath smells very foul, and the teeth become loose in their sockets. Great muscular weakness, faintish attacks, dropsy, looseness of bowels, delirium, &c., occur
in advanced stages of the disease. Death arises from exhaustion or loss of blood.
The treatment, if well directed, may restore persons apparently hopeless, and that with con siderable rapidity. It consists in supplying to the food the ingredients that have been absent from it. This is done by the use of fresh vege tables, potatoes, carrots, turnips, green vege tables, oranges, lemons, &c. Lime-juice also is a valuable restorative. One or other of these kinds of food must be added in considerable quantity to a diet otherwise nourishing. Mean while the person must rest for a time till danger of fainting or attacks of bleeding has passed away. The English Board of Trade now com pels emigrant ships to carry a certain quantity of vegetable diet for each person, and sufficient lime-juice to supply 3 ounces weekly to each person. Merchant ships are also required to carry lime-juice for the crews, each man to receive 2 ounces weekly, and more if signs of scurvy appear.
Purpura is attended with escape of blood beneath the skin and mucous membranes, and is, like scurvy, due to a had condition of blood. It may occur at any age, but it occurs specially among young children, and not only the badly fed but the healthy-looking may be attacked.
The symptom because of which the disease is named is the occurrence of spots in the skin of a deep-red colour, from fliers points in size up to circular spots one-fourth of an inch across. The spots do not fade when pressed, and are not raised above the skin. The colour, at first deep-red, fades and becomes bluish, yellowish, and finally disappears just as the blue marks of a bruise fade. They occur usually on the legs. In severe cases large bleedings may occur not only under the skin but in the mucous mem brane of mouth, nose, stomach and bowels, bladder, womb, &c.; and the loss of blood thus occasioned may be so great as to produce great pallor, headache, fainting. The disease may occur suddenly among the apparently healthy, but it also frequently declares itself after preliminary symptoms of headache, weakness, and languor, loss of appetite, and rheumatic like pains in the limbs, lasting one or more weeks.