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Relapsing Fever

attack, bowels, hence and days

RELAPSING FEVER.

Relapsing Fever (Famine Fever—Bilious Remittent Fever—Seven-day Fever—lrish Fever). —This is a fever that seems to be related to periods when extreme poverty prevails, hence its term famine fever. So far as Great Britain is concerned, it came from Ireland, and hence was called Irish fever ; but it has also appeared in America, India, Africa, and Russia.

It is undoubtedly due to the presence of a living germ in the blood—the spirillum of Ober ineyer,--is contagious, and may be carried long distances by infected persons and by clothes.

Symptoms. — It is doubtful what period passes after the poison has been introduced into the body before the attack begins, some times apparently only a few days, at other times about a fortnight. The attack begins with shivering fits, pain in the forehead, back, and limbs, high fever, and great dryness of skin. Appetite is lost; there is thirst; the pulse is very fast ; the tongue is covered with a thick white coating, the tip and edges being red. The bowels are confined ; there is pain over the stomach, and to the right side over the liver ; and vomiting occurs. Jaundice, yel lowness of the skin, occasionally appears about the second or third day, hence the idea that the fever is a bilious one. The spleen and liver are enlarged and tender. Towards the end of the first week there may be delirium. In from five to seven days from the beginning of the attack the fever suddenly passes away, usually after copious sweating, lasting for a few hours, or after free discharge from the bowels. The

other symptoms improve,but the patient is left weak. For about a week lie remains apparently well, and then a second attack suddenly comes on, similar to the first, lasting about three days, and ending like the first. A third attack may follow. Purplish spots may appear during the disease, though there is no regular rash. There may be severe bleeding of the nose.

Deaths from relapsing fever are not common. Weakness produced by the fever is great, and recovery is slow. The complications apt to occur are affections of the lungs and bowels, looseness, and dysentery.

Treatment.—Light food of milk, corn-flour, beef-tea thickened with rice or co•n-flour, is to be given in small quantities. Cold sponging, when the heat is great, with water containing a little vinegar, is refreshing. The patient may have ice to suck, and tea-spoonful doses of the following mixture are to be given every three hours:— To relieve pains and help sleep 5 drops of lau danum may be added to each dose, but only to grown-up persons. The bowels should be moved by castor-oil or by injections. No medicine prevents the relapse. Recovery is to be aided by light nourishing foods and quinine tonics.

Disinfection (p. 516) must be practised.