Handbook for the ship's medicine chest / by George W. Stoner ; prepared by direction of the Surgeon-General.

  • Stoner, George W.
Date:
1904
Catalogue details

Licence: In copyright

Credit: Handbook for the ship's medicine chest / by George W. Stoner ; prepared by direction of the Surgeon-General. Source: Wellcome Collection.

    20/116 (page 14)
    is generally, hut not always, ushered in by a chill, which is followed bv moderate or high fever—101° to 105° F. (88.3° to 40. .V (\) ; hot skin, ({nick pulse (100 to 1*20 per minute) : flushed face, and watery, bril- liantly reddened eyes. The tongue is usually moist and coated, but soon becomes dry and pointed. Thirst is marked, the throat is sore, the stomach is irritable, and in most cases there is nausea and vomiting from the beginning. The bowels are constipated, the stools dark col- ored. The urine is acid, scanty, and apt to be albuminous, especially the evening urine. The presence of albumen on the first and second days indicates a severe case (Guiteras). The fever may last from a few hours to two or three days, but while the temperature keeps up the pulse steadily fails. Death may take place in this early or first stage of the disease. Usually this stage is followed by The second stage, or stage of calm, as it is called. During the stage of calm the fever goes down, the temperature drops in some cases below the normal, and the general symptoms subside. The skin may or may not be tinged. There is usually some yellowness of the eyes. In the milder cases this may be the beginning of convalescence. hi severe cases this stage of calm and apparent convalescence is followed, in twelve or twenty-four hours, by— The third stage, or stage of febrile reaction, when the struggle for life begins. The temperature now rises again, and the symptoms of the first stage recur with increased severity, and other and more serious symptoms are developed. The jaundice deepens, the pulse drops in some cases to 40 or even to 30 per minute, vomiting increases; the vomited matter may lie bile, blood, or altered blood (coffee-grounds black). The patient complains of severe abdominal pain. The stools are black and frequently of tarry consistence. The urine very scanty and albuminous. Bleeding may occur from the nose and from the mouth and gums. The strength rapidly fails, and the patient dies from exhaustion. In some cases even when black vomit occurs a change for the better takes place and the patient gradually recovers, but if black vomit sets in early in the disease1 it is nearly always fatal. In tlu4 u walking cases ’* a man may be up and about, complaining of only slight ail- ment, and be suddenly taken with black vomit and die. Treatment.—The milder and even the moderately severe cases may easily be mistaken for other diseases; but if a man is seized with an illness as above described, particularly if the ship is or lias recently been in a yellow-fever district or where yellow fever is likely to prevail, he should be placed in a clean, well-ventilated room, as far removed as possibly from the healthy members of the crew, and have one good and constant attendant or nurse, who may, if convenient, occupy an adjoining room wlum not in actual attendance at the bed- side, but who must be given to understand that his whole duty con-