The mouth always shows very characteristic features. The tongue is usually clean and small, although somewhat yellowish. Along the back and edges of the tongue, particularly along the root of the tongue, small, fine ulcers, covered with white pellicles, are very prominent. These may run into one another, and, by ulceration, form peculiar running sores. In patients who have been sick for some time, the fissures may become very deep, and the tongue takes on a glossy and varnished appearance. The taking of salt or very highly seasoned food brings on pain, and swallowing also causes sharp, shooting pains, showing that the disease is in the oesophagus as well. The diarrhoea is very constant, one or two movements a day, or even as many as eight or ten, being present. These pass in a liquid or semi-liquid condition, usually without pain, and are white and of a peculiar odour. The reaction of the stools is acid, and they have been compared to whitewash. Marked anemia develops, and the patients often die of inanition. The treatment is by means of an absolute milk diet, local applications to the mouth, reconstructives (such as iron and arsenic), and the taking of fresh fruit, particularly lemon-juice, strawberries and raspberries.
Tropical Dysentery is much more severe than the dysentery of the tem perate climates, but presents no other features that have not already been discussed in the article on DYSENTERY.
Tropical Buboes is a disease characterised by subacute inflammation of the lymphatic glands of the groin. It is usually attended by fever, which persists three to four weeks, and is of the remittent type. It is found in the Philippines, in the West Indies, in the Mediterranean region, and along the coasts of Africa and Asia. Soldiers and sailors are most often involved, and the disease is thought to be spread by the bites of insects. It is probably of bacteriological origin. The disease begins with a moderate tenderness and swellings of the glands in the groin, and the patient may have a chill, followed by fever, headache and backache. The buboes slowly increase in size, until they may become as large as hens' eggs. The fever abates, arid the symptoms subside after one or two months. Many of the glands suppurate, and ulcers form, with deep burrowing abscesses. After two or three months the disease subsides, and, after a long and painful convalescence, a cure is effected. Local treatment by iodides, iodine, and other skin stimulation gives the best results.
Lata is a peculiar manifestation of disease common in the tropics, par ticularly among the Malays. It is probably a hysterical manifestation, and is in need of further study. Certainly the lata as seen among the Japanese is purely hysteria, although not infrequently it may be complicated with certain forms of mental affection.
Amok is an affection seen among natives of various tropical lands. It has been thought to be a distinct disease, but is undoubtedly only a symptom of a number of insane states—dementia prxcox, epilepsy, and other psychoses —in which there is clouding of consciousness.
Ainhum is a tropical disease of the dark races, distributed in Africa and India and Brazil, and having occurred also among the negroes in the United States. The disease usually commences as a narrow slit, or groove, caused by the splitting of the fissure beneath the toes. This gradually becomes so marked as to cut off the toe from the foot, until it finally separates from gangrene. It probably is not a definite disease, but a symptom of a number of conditions, perhaps leprosy, perhaps other forms of trophic disturbance.
Madura Foot, or the fungus-foot of India, is a disease common to India, but not unknown in South America and the Southern States of North America. It is very closely allied to the condition known as actinomycosis, and most of the cases reported from the United States are probably this disease. It usually begins in one foot, commencing as a hard pimple on the sole, which gradually softens and discharges. A persistent sinus then is formed, and, by the occurrence of other nodules and other sinuses, a diffuse, thickened, inflammatory condition develops. This can only be treated by surgery, by the resection of the entire area, or by cutting off the foot.
Pinta and Tinea are forms of superficial skin-disease due to parasites related to those known in the temperate zones, although distinct from the latter. They are tropical forms of ringworm, and vary only by the greater severity of the affection. See RINGWORM.
Oriental Sores of various kinds are extremely common in the tropics. Most of them are instances of a .streptococcus infection, and arise owing to the filthy habits of the natives. They frequently involve the face, leaving scars with depressed, irregular, rounded edges. They are best treated on ordinary antiseptic principles.
TROPICS.—Anyone who journeys to tropical countries, no matter in what capacity, ought to remember that he is taking certain risks with regard to his health. The conditions which menace health in the tropics are, on the one hand, the climate, and, on the other hand, certain indigenous diseases, among which malaria ranks first. In order to reduce these dangers, only persons who are physically suited to live and work in a tropical climate ought to make the attempt. The age of the individuals is of great They should be neither too young nor too old, the years between twenty-five and forty being the most suitable. Further, their health must be good. and they should, particularly, be neither anaemic nor obese. They should be free from diseases of the lungs, heart, or kidneys, should not he heavy drinkers, and should not he predisposed to gastric or intestinal troubles, nor to rheu matism. Furthermore, a person having suffered from malaria, dysentery, or sunstroke, is unfit for service in the tropics.