llapse and purging disappear. After improvement, with slight rise of
temperature at times, there may be a relapse or the patient may have
inflammation of some of the viscera (cavity organs) and suppression of the
urine with delirium, coma and death.

The prognosis is worse in infancy, old age and debilitated persons, and in
cases of rapid collapse, low temperature and great blueness. Death rate
from thirty to eighty per cent.

Treatment.--Isolate the patient and disinfect all discharges and clothing.

Use boiled water during an epidemic.

For pain, morphine hypodermically, and apply hot applications to the
abdomen.

For vomiting.--Wash out the stomach and give cocaine, ice, coffee, brandy
or water by the mouth. Intestines may be irrigated with a two per cent
solution of tannic acid.

During collapse.--Hypodermic of camphor, hot applications to the body.
Good nursing and careful diet.

YELLOW FEVER.--Yellow fever is an acute infectious disease characterized
by jaundice, hemorrhages, albuminuria (albumin in the urine).

Cause.--It is common in the West Indies and epidemic in nearby countries.
It is most common in crowded, dirty, poorly drained portions of sea coast
cities. It is probably caused by a specific organism which is conveyed
from one person to another by mosquitoes and not in clothing, as formerly
believed. One attack usually confers immunity.

Symptoms.--Incubation is about three to four days. There may be a
fore-warning period, but the attack is usually sudden, with chills,
headache, backache, rise in fever, and general feverish symptoms,
vomiting, and constipation. Early in this disease the face is flushed,
while the conjunctiva and the mucous membrane lining the eyelids is
congested and slightly jaundiced. Fever is 102 or 103 degrees, and falls
gradually after one to three days. Pulse is slow, and while the
temperature rises, it again falls. The stage of calm follows the fall of
the temperature with increased jaundice and vomiting of dark altered
blood, the "black vomit." Hemorrhages may also occur into the skin or
mucous membranes. Brain symptoms are sometimes severe. Convalescence is
usually gradual. The disease varies from great mildness to extreme
malignancy. Mortality from fifteen to eighty-five per cent.

[INFECTIOUS DISEASES 225]

Treatment.--Prevent spread of the infectious mosquitoes; use screens and
netting in infected districts. Careful nursing, food by rectum while
vomiting is