Dengue gives rise to a marked post-orbital soreness rather than pain. There is also a marked rachialgia with pains in the limbs often referred to the regions of the joints, which, however, are not swollen.
In Malta fever the neuralgias, especially sciatica, often associated with suddenly appearing, painful joint swellings, are prominent features.
In trypanosomiasis headache is often marked, together with a characteristic deep hyperaesthesia, so that the striking of a limb against a hard object gives rise to excruciating pain, there being, however, a delay in the experiencing of the painful sensation.
In relapsing fever the headache is often intense with pains in the back and bones.
In cholera one of the most striking phenomena of the disease is the terrible cramping of the muscles, especially those of the calves and feet. These pains actually torture the patient. Cramps of abdominal muscles as well as those of extremities are often noted in heat stroke in men in firerooms.
In beriberi there is often pain in the epigastric region so that the slightest touch causes great distress. This epigastric tenderness is also a feature of yellow fever. The calf muscles are also markedly hyperaesthetic in beriberi.
In leprosy the neuralgic pains may be very severe while the nerves are being pressed upon by the connective tissue increase of the endoneurium and perineurium. Mention has been made of excruciating pains of toes, especially the big toe, even suggesting gout.
The excruciating pains of Oroya fever are connected with the changes taking place in the bone marrow. There is probably more rapid alteration in the blood picture in this disease than in any other. It might be designated a fulminating pernicious anaemia.
Pain on pressure on dorsal or lumbar spine is common in pellagra.
Plague may be associated, during the first day or two, with an excruciating headache. This may even be prodromal but tends to disappear with the rapidly developing stuporous state of the patient.