The Houston daily post. [volume] (Houston, Tex.) 1886-1903, 1897-11-17

yellow fever corresponding in intensity
with these present at the same time such
characteristic features that 1t Is impos-
sible 20 mistake them. The difficulty Of
diagnosis can emily be met with in connec-
tion with mild cases.
The third characteristic symptom OF
this disease is the want Of correlation
between the pulse and the temperature.
This may be rather late manifestation
and may be absent. especially in children.
1t should be remembered that the chArac-
teristc feature of yellow fever in this
connection is not a slow pulse during the
conyalescepce, or even during the defer
vescence Of the fever. The characteristic
feature is that quite often we find that
at the same time that the temperature
may be rising the pulse may be falling.
On the third or the fourth day of the
disease. for instance. with an evening exa-'
cerbation OF half degree or enc degree
OF temperature, we may find that the pulse
is perhaps ten beats slower than in the
morning. l have seen, however, the same
discrepancy in cases of true dengue, and
in the tropics also. in connection with other
febrile diseases. Still this Is exceptional
In dengue the excessive fall of the pulse
presents itself with a distinct deferyes-
cence of the temperature, and | suspect
that many cases that are reported from
cuba OF slow pulse in typhoid and lnalarial
tevers may have been cases Of yellow
fever.
An erroneous belief has prevailed
throughout the South, especially among
PHYSICIANS who We're not practical micro
scopists. that the microscope should he an
important aid in the diagnosis OF yellow
feVer. 1t appears that poorly prepared alb
s'racts from the work OF Sanarelli have led
many to believe that characteristics fea
tures-the bacillus of Sanarelli itself
were found on examination Of the blood.
Now the truth is that even with the as
sistance of post mortem examinations
Sanarelli was able to discover his bacillus
IN 90 per cent only of the cases of yellow
ieVer. he would be poor cliniciau. in
ueed, VINO could only diagnose about one
half OF the cases. The sruth is. however
That during life the microscope could NOT
estapiish positive diagnosis. AS far as
our present methods go, it would he i'm
possible to distinguish between a dron NJ
yellow fever blood and blood from a
healthy man.
!, Negative evidence may be presented NV
the microscope. The presence of the Mas.
modium malariae, for instance. would
prove tnat a case WAS suffering with ma
ta,iai poisoning. and presumably. not with
yeilow iever. But the differential diapno-
Sis between thsee two diseases is USUALLY
easy. Inc bilious remittent fever that In
our old text books OF medicine occunied a
conspicuous place in tables of dfferenfjoi
diagnosis with yellow fever, has practi-
ealiy disappeared from the Southern Sea
border, since yellow fever ceased n No an
epidemic there. 1t was. in fact The va,,a a.
FEVER Of the natives and of places in The
interior. The former was supposed IN nos
sess certain degree OF immunity against
!eto" Iever' ana the disease was believed
10 be restricted almost to the littoral.
the piasmodium has been found in the
oioou IN cases or yellow fever. The mis-
take made by the board of EXPERTS ~ Nar
Orleans, when they faiad to recornizo NV
existence OF yellow fever at Ocean Sprinrs
was due to the finding OF the plasmod,n,,
IN an least two OF the cases.
me prevalence of a widespread mild
epidemic fever during the present outbrean
OF yenow lever has been undoubtedly n
lion with the diagnosis.
Many OF these cases were found 20 av,s,
IN houses where cases OF yellow sayar
were present at the imo and nm, ~
Tess that 1t was impossible IN disc,var ~
them any OF the Characteristic svr,r,,, ~
OF yellow fever. Many OF these cases baa
distinct eruption and must b. lookei unar
as cases OF dengue,' This fact may hing
forward new problems as to the relations
present point Of view, We can on,v
That yellow fever appears to soread ,,are
easily when there is an epidemic ~ dans,,s
prevaiiins' All evidence goes to show ina,
previous attack OF dcnsue does NOT nroe
tecb against yellow fever, and we must
JOCK upon the fosmer as an entirely ais.
tinct disease. ais-
! can not insist too much upon the i'm
portance OF the diagnosis OF the first case
% Yellow FEVER IN locality. Undoubtedly
the cause Of the epidemic of yellow ,sras
10 to be found In the instroduetion int
community of CASES that are not susnsct a.
70 be yellow fever. This probably occurs
most frequently connection with ndiyids
uais OF the colorcd race. The disease n
them 10 usually very mild. and their move -
menss from place to place are less likely
% esract the attention Of tho health an.
tnorsues have no hesitation In saying