It is best to give the patient abundance of fresh air so that tent treatment is to be recommended. Cool sponging lessens the nervous manifestations as well as lowering temperature. Ice bags to the head relieve the headache. Cardiac stimulants are indicated, as caffein and camphor. Thyroid extract has been recommended. Lumbar puncture has given amelioration of symptoms. Abundance of water should be given and the diet should be milk and broths.
The virus of typhus is present in all the organs of an infected guinea pig and Nicolle has prepared a serum by injecting horses with emulsions of spleen and adrenals of such animals. The serum has apparently given good results in human beings when employed early in the disease, the temperature falling with each injection. The dosage was about 20 cc. daily.
CHAPTER XL
TRENCH FEVER
Definition and Synonyms
Definition.—Trench fever is a specific, acute infectious disease, probably caused by Rickettsia quintana, acquired usually through the agency of the body louse, characterized by an abrupt onset, a febrile period of about five days often followed by one or more relapses, and ending in complete recovery.
Trench fever was one of the most widespread diseases occurring in the forces of the World War. It is transmitted by contamination of a skin abrasion or of a louse-bite wound with the faeces of an infected louse, although Strong and his colleagues reported the bite of an infected louse as a demonstrated method of infection.
Clinically, it shows an abrupt onset, with fever, headache, pain on moving the eyeballs, soreness of the muscles of the legs and frequently hyperaesthesia of the shins. As a rule the initial fever is followed after a few days by a single short rise but there may be a fever course of many relapses with apyretic intervals. Recovery is complete, death practically never occurring; but convalescence may be protracted, and incapacitating after-effects, such as neurasthenia, cardiac disturbances and myalgia, may be noted.
Synonyms.—Pyrexia of Unknown Origin (P. U. O.), Meuse fever, Volhynian fever, Shin fever, Quintan or five-day fever.