Symptoms.—The usual symptoms in the adult are a brawny swelling in the region of the sting and more or less collapse. There is often severe pain of a throbbing nature, and there may be sickness and vomiting.
Treatment.—Apply a tourniquet above the sting and incise the affected area; then apply an opium lotion. This is usually sufficient to afford relief and prevent extension of the swelling. A serum suitable for use in Egypt and the Sudan only, has been prepared for treating scorpion stings, and when it is available it should be used as soon as possible, as very favourable results have been reported from its employment. It can be obtained in Cairo or in this country from Messrs. Allen and Hanbury.
Spider bite is not so important as scorpion sting, though poisonous spiders do exist in various parts of the world and belong to a genus found in Southern Europe, New Zealand, and various parts of North and South America. Many of these poisonous spiders are brightly coloured, their abdomens being spotted with vermilion. In Peru there is a so-called “pruning-spider,” which belongs to another genus and is also poisonous.
Symptoms.—Locally a reddish papule appears, and there is sharp stinging pain. The papule is followed by a spreading inflammation which sometimes goes on to gangrene, though this is rare. The general symptoms are those of nervous exhaustion and there is high fever, rapid pulse, rapid breathing, and sometimes blood in the urine.
Treatment.—Apply a ligature and suck the wound. Use permanganate of potash locally as in the case of snake-bite. The permanganate should also be given internally, one-quarter to one per cent. solution being given every hour or every two hours. Diffusible stimulants such as ammonia, caffeine, or camphor are useful as diuretics. A strict milk diet should be enforced during treatment.
Scurvy.
This is one of the deficiency diseases. This is not to say that mere general starvation will produce it, but that it is due to the lack of certain substances in the diet. These substances are known to exist in fresh fruit and vegetables, and also to a lesser extent in fresh meat and raw milk, but their exact nature has not yet been determined. Travellers should remember that, apart from the actual disease, there is a scorbutic state in which the symptoms are indefinite, and which, if not recognized and promptly treated, will pass on to true scurvy.
Symptoms.—Scurvy begins insidiously with progressive weakness, pallor, loss of weight, and stiffness in the leg muscles. Later the gums become affected, soft swellings sprouting up between the teeth. As the disease progresses the gums become swollen and spongy, ulcerate and bleed, while in bad cases the mouth becomes very offensive and contains large fungating masses. Other signs of scurvy are hæmorrhages under the skin and mucous membrane and in the muscles. Any injury is apt to be followed by hæmorrhage. Swelling of the legs is an important symptom, especially in the region of the ankles. If untreated, the condition becomes worse, the appetite is impaired, mental depression sets in, there is breathlessness on exertion, and night and day blindness. Death results from heart failure or some complication.
Prophylaxis.—Ensure a good dietary containing sufficient anti-scorbutic elements. Wherever possible, fresh meat, fresh vegetables, and fresh fruit should be supplied. Lemon juice is valuable. It should be noted that it is four times as efficient as the lime juice which used formerly to be employed. The ration should be one ounce daily served with sugar. Germinating peas, beans, and other pulses contain the anti-scorbutic elements in large quantity. It is a simple matter to carry a supply of these pulses and to germinate them when required. The dry seeds must be whole, retaining their original seed-coat. In order to make them germinate they are placed in a clean sack and steeped in a vessel containing clean water, which should be occasionally stirred. Sack and trough should be large enough to allow for the swelling of the pulses to about three times their original size. In a hot climate six to twelve hours is sufficient for this soaking. Thereafter, lift the seeds out of the water and spread them out to a depth not exceeding two or three inches in some vessel which allows free access of air to them. Keep them moist by covering with sacking, which is wetted at intervals. The germination should reach the stage necessary within twenty-four hours in a hot climate, and the pulses should be cooked and eaten as soon as possible after germination. Care should be taken not to overcook them. At a pinch germination may be effected by placing the seeds between wet blankets, but this is a rough-and-ready method not to be recommended.
It is important to attend to oral hygiene, especially the regular use of the tooth-brush. Vegetables should never be overcooked. In the case of African native followers Kaffir beer made from germinated grain is of great value; one pint should be given daily per head. Potatoes and root vegetables are useful, and the onion is a valuable food in this connexion. Fresh meat is not so effective as either fresh fruit or vegetables.