Clinical lectures on dengue / by T. Edmondston Charles.

  • Charles, T. Edmondston (Thomas Edmondston)
Date:
[1872]
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lectures on dengue / by T. Edmondston Charles. Source: Wellcome Collection.

    39/60 (page 29)
    the fever may even last for twenty-four hours, and the pains of the first attack may return in the relapse : usually, however, in a modified form. In rare cases a more severe form of relapse than this even is met with, in which temperatures over 104°F. may be noted. I have seen such a relapse occur on the third day, some twelve hours after the first attack was over, and when it occurs on the fourth day or later when the secondary rash is out, a high temperature with a measly rash is apt to lead you to make a diagnosis of measles. I wish you to keep this fact in mind, as I shall have to refer to it again. I have never been able to notice any regularity in the occurrence of these relapses, and can not lead you to any law which guides them. Perhaps more close watching may enable you to make advance in this direction, but, for the present, I can only regard them as accidental manifestations, not fol¬ lowing any system in their coming or remaining away. This tendency of febrile action to recur is one of the features of dengue which deserves prominent mention, as I do not think you meet with it in any of the other febrile exanthematia, except as an index of serious local disease, while here it has no such significance. These relapses chiefly take place within the first ten days after seizure, but a condition sometimes remains which seems to render persons liable to irregular attacks of fever for long after they are well and about. Even when no relapse has taken place immediately after the attack, such people now and again get fever for a few hours—while they never before were liable to similar attacks, and seem thus to be rendered easily affected by influences, which would not pre¬ viously have influenced them. You will do well not to regard these attacks of fever as specific in any way, as they probably depend on the weakening tendency of an attack of dengue, which, lowers the powers of resistance of the individual, and makes him an easy prey to even slight exciting causes of disease. I have more than once seen repeated relapses within the first ten days after the attack in those who had been much subjected to malarious influences. The curves illustrating the temperature in relapsing dengue require little comment. In the case of the adult on the fourth day the temperature rose to over 104°E. In both cases quinine was given as soon