Malaria and malarial diseases / by George M. Sternberg.

  • Sternberg, George Miller, 1838-1915.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Malaria and malarial diseases / by George M. Sternberg. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    a form that all of the characters commonly relied upon for making a diag- nosis are wanting, and these cases of typhoid poisoning may be complicate'! by the most decided evidences of malarial poisoning when the case occurs in a malarious region, or in an individual who has been recently exposed in such a region. It is also pretty well established that a non-specific continued fever may result from exposure, in overcrowded and illy ventilated apartments, to the noxious emanations given off from healthy human bodies—crowd poi- son—and from decomposing animal matters in cesspools, sewers, etc., the idio-malaria of Dr. Edward Miller. This kind of malaria has been denom- inated civic malaria, and there is no objection to this term, if we are at the same time permitted to qualify our malaria by the adjective paludal. But the objection is raised that this implies that it originates only in swamps, which is not true. If, therefore, we admit the force of this objection we are reduced to the necessity of using the word malaria by itself to indicate the toxic agent which produces the periodic fevers, and as this use of the term has the precedence, and is generally adopted by medical authors, we must object to the indiscriminate use of the term which is now so largely made, especially in those portions of the United States where malarial dis- eases, properly so called, are comparatively rare. Evidently the term civic malaria is open to the same objection as has been raised against paludal malaria. This kind of bad air is not alone generated in crowded cities ; it may also be encountered in its most atrocious and concentrated form in country villages, and even in the hut of the agricultural laborer and in the dug-out of the mountaineer or miner. We shall now proceed to consider the facts relating to certain forms of continued fever commonly ascribed to the influence of malaria, and which are known by local names in various parts of the world. Naples Fever. Dr. Borelli,1 Professor of Medicine in the University of Naples, has given a very interesting account of this fever, which by many is ascribed to ma- laria. According to this author cases of true malarial infection, of well- pronounced type, are rare in the interior of Naples, whereas the so-called Naples fever prevails most extensively in the central portion of the city. The opinion is expressed that typhoid infection is at the root of this form of infection, which exhibits every grade of violence from the mild and ab- breviated forms, to which the name febricula is given, to complete and rela- tively severe typhoid. In all of the varieties intermittence is a symptom repeatedly observed. Dr. Borelli says that if the febrile intermittence de- pended upon a malarious element, the salts of quinine ought to cure it rapidly, yet they invariably fail, and remarks further that: In paludal infection, when the fever assumes a quotidian type, each fresh access almost invariably begins during the forenoon ; whereas in in- termittent typhoid, the type, although quotidian, has an evening rhythm— that is to say, the exacerbation occurs in the afternoon or evening, so that in that respect it resembles all those spurious intermittent fevers which accompany the other diseases that I have mentioned —tuberculosis, case- ous inflammation of the lungs, chronic inflammations of serous membranes, pyaemia, etc. We may remark that, in general, all forms of septic poi- soning give rise to fevers having an intermittent or remittent type.