Yellow Fever (Black Vomit—Yellow Jack) is a disease of hot climates. Cold kills it. It is rarely absent from the West Indies, and is most fatal from May to August. It is due to an organism, but, like ague, is not communi cable from person to person. The infection is carried by the common brindled or tiger mos quito (mica), by whose bite it is conveyed to the human being. The infection can be carried by clothing, and conveyed by infected ships. A person who has suffered from one attack is safe from a second.
The symptoms may appear within one or two days after the poison has entered the per son's body, or may not occur for six or ten. The attack is sudden, beginning with shivering, fever, dry skin, intense headache, pain in the back and limbs. The eyes are glistening, blood shot and red ; the face is congested ; there are great thirst, Joss of appetite, tenderness over the stomach, sickness and vomiting. The tip and edges of the tongue are very bright red, the rest being covered with a white coat. The lips and throat are also bright red. The pulse is at first very fast, but may greatly diminish in speed, even while the fever remains high. The fever may not remain high for more than a day or two, but the vomiting and tenderness over the stomach continue. At first the vomit is of the contents of the stomach, then it becomes coloured with bile, and later has a " coffee grounds" appearance, the black vomit, due to mixture of altered blood. The motions are often black for the same reason. By the second or third day of the disease the whites of the eyes may be seen to be yellowish, and the yellow ness spreads to the face and over the body.
The urine, which is at first clear and of the usual quantity, becomes, with the advance of the disease, of a deep yellow from the presence in it of bile. The colour may deepen to orange red, and at the of the attack almost no urine may be made. In favourable cases the quantity becomes large and the colour becomes very dark. Death may take place within a few hours of the attack, the person becoming collapsed. It may occur, owing to bleeding from stomach, bowels, or kidneys, or from heart failure, at any time in the progress of the dis ease, the fifth day being regarded as critical. Recovery is gradual, and the jaundice takes long to disappear. The death-rate is very high.
Treatment.—The patient should be confined to bed and all exertion strictly forbidden. The room should be large and well-aired, but kept constantly at a moderate warmth. The bowels should be relieved by injections. Corn-flour, beef-tea, chicken-broth, milk, and similar food should be given at regular and short intervals. Lemonade and barley-water are allowed. To allay sickness ice is to be sucked, and mustard poultices applied over the stomach. In cases of recovery the person must not be allowed to sit up till fourteen days have passed.
All discharges from the patient must be at once disinfected, as recommended on p. 516.