The eruptions tend to come out in crops and the duration of the disease extends over two or three months.
Treatment.—The ordinary principles of cleanliness apply to the care of the lesions to prevent secondary infections. When the large tumor-like masses begin to ulcerate or become gangrenous they should be excised. It must be remembered that dangerous bleeding may occur at unexpected times, for which reason the patients should be provided with styptics or compresses to prevent serious loss of blood.
CHAPTER XXXVI
DENGUE AND DENGUE-LIKE FEVERS
Definition and Synonyms
Definition.—Dengue is an epidemic disease due to an ultramicroscopic, filterable virus which has been stated to be transmitted by Culex fatigans. More recent work points to Stegomyia.
It is characterized by an initial three or four-day febrile paroxysm of very sudden onset, a remission, which comes on about the fourth day and a terminal rise of temperature for two or three days—the saddle-back temperature course.
Backache and pains about the muscular attachments at the joints and especially a marked postorbital soreness are important features.
An eruption appears about the third or fourth day. Leucopenia and polymorphonuclear reduction are constantly noted. Apathy and a mild neurasthenic state may continue into convalescence.
Synonyms.—Dandy Fever (the word dengue is supposed to be derived from the Spanish equivalent of dandy or denguero), Break-bone Fever, Bouquet. German. Dengue-fieber.