The Pacific commercial advertiser. [volume] (Honolulu, Hawaiian Islands) 1885-1921, 1905-02-06

Below are extracts from the pape
read by Dr. A. n. Sinclair before tn
Hawaiian Medical Association on Sat
urday evening last, on the subject
"Fevers in Hawaii, and Their Relation
to Malaria
FEVERS IN HAWAII AND THEIF
RELATION TO MALARIA.
The subject for discussion this even
ing, and for which this paper is tc
serve as an introduction is: Fevers II
Hawaii and Their Relation to Malaria
While this title might mean that
was to enter into discussion of al
the fevers, as observed in Hawaii,
feel that I am not qualified to do this
nor would you therefore be prOfita bly,
employed in listening to me.
! The general run of fevers, as far as
1 have observed, do not differ mate
rally from what one would expect IN
tropical country, except in one nota-
BILE instance and as L have seen quite
a number of these cases, and made
notes upon them. I intend to confine
myself almost entirely to that subject.
/ What is this fever perhaps the most
common one in Hawaii. and which so
far as I know is not described in the
textbooks? Is it a form of enter1c
fever? Or is it a form of malaria? Or
is it distinct in it's pathology from
either of these?
Firstly in answer to its connection
with enteric fever. the almost constant
rapidity of onset is enough to put that
disease out of consideration.
For want of better name I will,
for the time being, designate the form
of fever I am attempting to describe,
as Hawaiian fever.
Hawaiian fever generally starts with
a rigor, enteric rarely does. In Ha-
waiian fever there are no prodromal
symptoms, such as malaise, nose-bleed,
etc. There is not the characteristic
terrace" formation of the line as ap-
pears in enteric on the temperature
chart. Furthermore delirium is of rare
occurrence. and there is not any rash
accompanying the fever.
When one meets a case of enteric
fever in practice, there is not much
difficulty in distinguishing it as differ
ent from the common or a typical
fever. and finally we have the court of
last resort to serve as distinguishing
enteric from anything else, Hawaiian
fever included. Widals test
1 have examined a few cases of Ha-
waiian fever by Widals test but never
got any reaction even in a dilution 1
to 10, and as these cases were all pro-
tracted ones, and the examination was
made al the end of the second or third
week of the disease. I feel safe in as
sorting that Hawaiian fever is not a
form of enteric.
In my next statement I am going
to lay myself open to much criticism,
perhaps of a harsh character. 1 am
going to say that Hawaiian fever not
only is not a form of maIarial fever,
but more, I do not believe that mala-
ria exists in Hawaii at all. Of course
you will understand that I believe it
possible for case of malaria to be
imported into Hawaii in a dormant
state and develop after the patients
here it ceases.
1t is not carried to any other person, |
and consequently can not be said to be
a fever of Hawaii.
My reasons for making the above |
assertions are:
1. So far as have observed, the |
symptoms and course of Hawaiian |
fever are not those of malaria.
IIG Clti dCISliSllc dCIiOtl OF Jul |
nine in malaria is not only absent. but |
believe the administration of quinine |
in Hawaiian fever to be harmful
3. I have never been able to find |
the plasmodium of malaria in any case |
of fever in Hawaii, except one i'm |
ported case of malaria.
4. There is not the requisite condi- |
ton, Or the host of the malaria or |
ganism, while outside the human body. |
to receive the malaria germ or carry |
it about, the anopheles mosquito.
CDR. Sinclair here discussed al length |
the symptoms and treatment of Ha- |
waiian fever, citing cases from his |
practice, which he illustrated with |
charts. His data showed |
how quinine rather aggravated than al !
leviated Hawaiian fever He had eX-
amined the blood in 120 cases and never |
found a plasmodium resembling that of |
THE ANOPHELES MOSQUITO.
Finally in regard to the anopheIes |
mosquito:
To make this argument stick it is |
necessary for me to briefly discuss |
whether or not malaria can exist in a /
locality where there is no anopheIes |
lin the air" character about this argu-
ment, in more ways than one. But ex-
periments have proven and the vast |
of observers coincide in the |
belief that the anopheles mosquito, and |
this agent alone, is the sole vehicle OF |
As regards the other genera of mos |
1uitoes: experiment has shown that the |
0Hlariql MIA in, oil Of
complete its second life cycle.
in them just as ingested. The
male and female forms do not unite.
and there are no new forms evolved |
to be injected into the next victim the
mosquito may run across.
If anopheles then, is the only form
or genus Of mosquito that can carry
malaria, can it be carried by other
agencies than by mosquitoes?
Air. water and food have been blamed |
F.r4-