Kubisagari is another disease concerning which very little is known. It is not strictly a tropical disease, but is found in northern Japan, and has some relations to a peculiar disease described by Gerlier as occurring in natives in the mountains of Switzerland, who live in their chalets with their farm animals closely around them. It is not unlikely that the disease has some relation to the family periodic palsies. It attacks all sexes, principally in the warm months, and is a very chronic disorder. Kubisagari manifests itself in the form of attacks which come on at intervals of a few hours to several days, and persist for a few moments to several hours. Either hunger, fatigue, or sudden excitement may be the of an attack. Suddenly there develops a marked dimness of vision, the patient sees double, and there is paralysis of the eyelids. Also, other muscles may suffer signs of weakness. The head often cannot be held erect, but drops forward, this particular attitude having given the name to the disease. Swallowing may be rendered difficult, and even walking made impossible. Between these attacks the patient seems perfectly normal, save at times for the persistence of the paralysis of the eyelids and the weakness in the muscles of the neck. Most of the patients get well.
Atriplicism is a rare form of poisoning by a species of Atriplex, a common weed of China, used as a salad. Within ten to twenty hours after eating the weed, there is noted a tingling of the fingers and back of the hand, which is soon followed by a swelling in the hand itself, and an itching which spreads up the forearm to the elbow. The face may later be involved in the same manner. The itching and swelling continue from two to ten days ; and, after the superficial layers of the skin are exfoliated, healing takes place, interrupted in some by the formation of blebs or ulcers. Local sedatives give good results.
Lacquer-Poisoning is a form of poisoning common to Japan, where the exudation of a species of Rhus is widely used in the manufacture of the black lacquer so much employed in all Japanese work. It resembles the poisoning due to other species of Riots (poison-ivy, poison-oak), which are so well known, save that it is much more severe. Local sedative applications are employed in the treatment. The gingko-tree, so widely introduced from Japan for use in public parks for the past ten or fifteen years, is said to cause a similar form of poisoning. No authentic cases are on record, however, and an active handling of the leaves and fruit has not caused any poisoning.
Lathyrism, or chick-pea poisoning, is a common form of poisoning of cattle, although not so common with man. The disease is present in
tropical countries where certain species of vetch abound, notably in Italy, France, Algiers and British India. It is known also in the southern United States and South America. The seeds, like small peas, are often used as a food, or as an addition to food in times of shortage ; and when eaten for some time (several months), give rise to serious, even fatal poisoning. Fever, dyspepsia, and intestinal symptoms usually precede the more severe signs of pain in the loins, legs and knees, with weakness and tremors. Then a stiff, paralytic condition, accompanied by spasms, develops in the legs ; the knee-jerks are exaggerated, and there may be sonic disturbances of the bowels. The disease may involve the bladder, though less often. Perma nent paralysis may remain. The spinal cord usually shows signs of degenera tion. The treatment is by withdrawal of the seeds ; otherwise purely symptomatic. The best treatment is by education. The public should recognise the dangers that may arise from eating these seeds.
For the treatment of bites by poisonous snakes, see the article SNAKE BITES.
Tapeworms and various other intestinal parasites ai e extremely common in all tropical countries. The filthy habits of the natives and the lack of sewage systems render it impossible to cope with these diseases. The methods of prevention are deScribed in the articles on PARASITES ; TAPEWORM ; WORMS.
Sprew or Psilosis is a widespread tropical disease of very grave import, and should not be confounded with what is termed aphthe, or sprees of children. It is present throughout the entire tropical world, and has received various names, such as white diarrhoea, Ceylon sore mouth, the " white flux," etc. It seems to be a general catarrhal process of the intestinal canal, associated with a number of infectious organisms which fasten themselves upon the devitalised body. A form of awake is very widely present in these cases. Intestinal parasites are also very common accompaniments, uncinaria being one of the most important. It should be borne in mind that soldiers or citizens who have been in the Philippines for any length of time may develop the disease, which may lie dormant for a number of years after the return of the colonist to his home. The disease is very chronic, usually persisting a year or two, or even longer, the patient becoming thin and pale, and his complexion muddy and sallow. Nervous irritation, with lassitude and weakness, is pronounced ; and sore mouth, diarrhoea, and excessive development of gas in the intestines may be present.