Report on the malarial epidemic fever of Mauritius of 1866-67, (with plans of Port Louis and Flat Island, and a map of Mauritius, shaded to show the distribution of the fever districts) / by John Small and W.H.T. Power.

  • Small, John, Surg.-Major.
Date:
[between 1870 and 1879?]
Catalogue details

Licence: Public Domain Mark

Credit: Report on the malarial epidemic fever of Mauritius of 1866-67, (with plans of Port Louis and Flat Island, and a map of Mauritius, shaded to show the distribution of the fever districts) / by John Small and W.H.T. Power. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    posure to the sun, with mdiflferent food, acting on men who had been exposed to the nifluence of malana ; this remittent fever, as also the bilious remittent are unfortunate terms, for most assuredly these terms were used very loosely the former to mean a severe fever in which the three stages were confused or wanting ; in fact, most were cases of the severe continued malarial fever • the latter we believe to be simply cases of malarial fever, in persons whose previous attacks had been neglected, or who had had many previous attacks of malaria informer years, and this form occurred especially amongst Indians and others who had of course been malariaUzed in their native land before coming to Mauritius ; no such cases of excessive bilious vomiting occurred in the 13th Regiment. When it is stated that remittent fever or bilious remittent fever occurred largely in the civil population, little more informa- tion can be derived from these terms than, that amongst them, the fever was complicated by neglect, want of proper food, and especially of quinine &c • great numbers of those who were found dead in houses or elsewhere died of what we shall present refer to, viz., malarial collapse ; in other words the word remittent did not, as it ought, refer to a fever with remissions instead of intermissions, but merely meant severe neglected fever arising from malaria. The symptoms were so much the same as usually laid down, that it is unne-' cessary to take up space in describing them. 4. Malarial Collapse:— Remarks.—Bj this term, we mean a state of profound ang^mia, from the blood poisoning effects of malaria; the symptoms come on with little or no warning. A patient has had one or more attacks of malarial fever (the fever itself having not been necessarily severe) ; instead of convalescing as usual, the patient became weaker and unable to walk, and so on ; the appetite might be fair ; tongue was clean, though pale ; in fact, no marked symptoms of any kind beyond a general debility and weakness ; suddenly, after having, perhaps (though not at all as a rule) complained of slight cramping pains in the muscles of the legs, the patient apparently goes to sleep, and if observed shortly after is found in a state of profound coma, with pupils dilated (more or less widely, according to the length of time he may have been in this comatose condition) gently breathing in slight gasps (not stertorous) body and extremi- ties cold, pulse weak, or not felt at all. The cases of this form which occurred in our regiment were of men, who having shown for some time no signs ot fever itself, were not treated with quinine, as we were compelled for a short time to husband our stock of this drug while we were at Flat Island, and it was only there that such cases occurred ; cases, however, such as these formed a very large, indeed the chief proportion of fatal cases amongst the civil popu- lation ; men laid down, this coma came on them, no one near to give the full dose of quinine, death inevitably resulted ; nature in such cases beiug power- less to heal, they passed slowly from this death-like state of coma, without at any time regaining sense, into death itself; this form is quite distinct and far more deceptive than those cases of severe continued malarial fever, which, however, if unchecked, pass through this stage of coma on the road to death. This form of collapse, not immediately following severe malarial fever, has been, as far as we can ascertain, not noticed prominently in such works on the subject as we have been able to consult, and as its recognition is of truly vital importance, it may be as well to dwell rather more in detail on it, and give such cases as occurred in the regiment when at Flat Island. Case 1.—Private W. Travers, age 23, service 4 years, a healthy-looking young man who had had several slight attacks of ague in Port Louis (as was only found out after his death). He had been attending at the hospital tent in camp at Flat Island from 12th to 18th April, for a slight attack of ague, and was treated with arsenic ; but though he lost the fever he got weaker, and was taken into hospital on the 18th. He had no return of fever while in hospital, and appeared to be doing well, but was very weak. He was treated with diu- retics, and had 6 grains of quina given him on the 21st. On the morning of the next day he was insensible and comatose, having but half an hour before asked the orderly to rub his legs, as they felt a little cramped; then turned round as if to sleep. No one noticed his condition until at 7 a.m. (half an hour afterwards) when the Medical Officer found him cold and comatose, with dilated