During the recent pandemic of influenza there was a frequent complication of influenza pneumonia; many of these influenza bronchopneumonias resembled plague pneumonia.
Tetanus.—This infection is far more prevalent in tropical than in temperate climates. It is particularly fatal to infants, the infection occurring from errors in the dressing of the cord at the time of childbirth.
Syphilis and Other Venereal Diseases.—Syphilis is rampant in many parts of the tropical world. Jeanselme has noted that syphilis among tropical natives often starts with an extra-genital lesion which tends to become phagedenic and that the secondaries are but slightly marked. It is in the tertiary stage that the disease shows itself in its malignancy.
All tropical workers have noted the absence of tabetic and paretic manifestations in the native syphilitics. LeDantec notes that he has not observed parasyphilis in any European who had contracted syphilis from a native woman and brings up the question of a difference in strains of syphilis.
The American Naval Surgeons at Guam and Samoa have been struck with the absence of primary lesions of syphilis among the natives of these islands and Butler has suggested that this is due to an immunity received as result of contracting yaws in childhood. There certainly are many reasons for considering syphilis and yaws as closely related.
Soft chancre is common in many tropical seaports and shows itself in a rather virulent form. In particular it is apt to be complicated by suppurating buboes.
In tropical gonorrhoea it would seem that involvement of the testicles is more common than in temperate climates.
Endocrine Disturbances.—Internists in all parts of the world are beginning to appreciate that many of the puzzling complaints of ill-health are connected with abnormal functioning of the ductless glands. The conditions resulting from excessive or diminished functioning of the thyroid gland are well understood and the determination of the basal metabolism rate is now a standard laboratory procedure. There are many types of apparatus on the market and the determination is within the reach of any hospital staff.
Hyperthyroidism is now rarely unrecognized as is also true of myxoedema but sub-states of thyroid functioning are less frequently recognized.