"SPOTTED FEVER."

Star (Christchurch), Issue 8351, 24 June 1905, Page 3

"SPOTTED FEVER."

America's Nervo-Plagua,

(Poll Mall Gazette,

The plague of cerebro-spinal meningitis which holds New York in thrall at present is by no means unknown in England, and a consideration of what it brings along with it is not unprofitable, considering the bacterial origin of the disease and the absence of any r&jtriotion on traffic between New York md Liverpool. We have interviewed one or two of pur best-known nerve specialists, and While admitting the keenest interest in |Ac pathology of the malady, they also admit that the actual experience of JBnglish medicine with regard to it is jmall. "It is not a novelty, of course," (paid the chief brain consultant at one 4 of our leading hospitals; "the germ is as well-established as any that we Icnow. In earlier times,- before the disease received close diagnostic criticism, it was proTTably put down as brainfever, and the associated symptoms jvere regarded as accidental rather than essential." "The best crusade you can ; preach," said another physician, "is the healthy life— personal cleanliness, iand attendance to the commonsense .'rules of sanitation." . ■ . , : -• AMERICA SPECIAIXY UABLB. There are various names for the epidemic, chiefly malignant purpurio ifever, petechial fever, and spotted -fever; and all authorities concur that while its clinical course is one of great irregularity, the disease is one with a High and swift rate of mortality. The 'first well-authenticated case on professional record is a small outbreak in 'Geneva at the beginning of last century, and in the following year it made Its' appearance in Massachusetts. This, and the warning of the previous year, brought it at once under close medical scrutiny, and in the epidemics that >have since occurred, America has had ..more than its share. There were intermittent outbreaks in the States from 1805 to 1830; a series in France from 1837 to 1850 ; another series in various* European nations from 1854 to 1874; and several fresh American epidemics at various dates until the present time, one of them affecting twenty-seven States simultaneously. In Ireland ■there have been a few outbreaks, but Great Britain seems to enjoy comparative immunity. We have had four epidemics, however, in 1846, 1866-7, 1885-6 ■■ and 1890, all slight by comparison- with ' the attacks in America. -PBEDISPOSItra CAUSES. It is noted that the disease is commoner in the winter and spring, and that a frequent cause is concentration of individuals, as of troops in large barracks. The congestion and squalor of the tenements in American cities are admitted to be fertile of the evil, and other factors favourable to its rise and spread are over-exertion, long heat marches, depressing surroundings and imperfect nutrition. It occurs largely among children and young adults, but, strange to say, it is not infectious in ■ . the ordinary way,- except \o a mild degree. The distribution in a city epidemic is very irregular, and there are five cases on record where the same individual has suffered from the disease twice.. 'But it is rare to have more than ' one or two cases under the same roof. .Boston, Philadelphia and Baltimore " have a certain number of cases every year. CASES IN" liONDON". - . Bacteriological examination has dis- , covered a germ that has been named ; -diplococcus intracellularis meningitidus, ', but particulars of this kind hardly ap- ' peal to the ordinary inquirer. In a ma- . jority of the acute cases death occurs within the first ..week, and this is one of the many points of analogy the disease bears to pneumonia. But although very few fevers kill so large a proportion of their victims, the general mortality is only slightly increased, for even during periods of prevalence very few individuals are attacked. Only once in twenty „ years, so far as England is concernetl, has the disease proved fatal to more ; than fifty people in one year. Dr Or- ' merod in the " Lancet " ten years ago ;.. described ten fatal coses, all occurring at St Bartholomew's Hospital, while at St Thomas's there were seven cases (not all . fatal) in the two "years 1895-6. j. THE SYMPTOMS. I The fever manifests itself abruptly, With sudden headache or nausea, and ■ "headache, usually., in the forehead, is ' intermittent and intense. This is often : accompanied by backache, stiffness of the neck and spasm of the spinal mus- : cles, so' that the head is in some cases -drawn baok upon the shoulder-blades. ■ Convulsions and partial or complete par- . • alysis are not unknown, and usually the • patient dreads being touched. Even in convalescence, the Drain processes are. yery much affected, even to the extent of delusion or partial insanity. The temperature is extremely- high and variable within the twenty-four hours, while the pulse also varies considerably. But the 11 Symptom /which gives one name to the .'• disease is a kind of herpes, or cutaneous affection, especially about the lips and 1 nostrils, the chest and abdomen _and fche" joints,- and, in some cases, the dark »pots have been likened to tiny bullets tinder the skin. The treatment usually ordered is a diet of milk, albumin water wad meat broth, with stimulants when ■^the'Wrt grows feeble, and warm baths three times a day. Opiates are administered to allay delirium.