For the sore throat, use an antiseptic gargle (see Ulceration of Throat, [p. 244]).
General treatment.—The patient must be put on a course of mercury at once. Calomel, one grain twice a day, or grey powder, one grain three times a day, must be administered, and continued until skilled advice can be obtained. The effect of the mercury must be carefully watched, and if the patient complains of soreness of the gums, a coppery taste in the mouth and excessive flow of saliva, the dose must be reduced or the administration of the drug stopped until these symptoms have disappeared. If the calomel or grey powder causes looseness of the bowels, five grains of Dover’s powder may be added to each dose.
In some cases, the addition of three grains of the iodide of potash to each grain of calomel does good from the very first.
For the later symptoms, continue the mercurial treatment, and give at least five grains of the iodide of potassium three times a day.
Since the above was written the whole treatment of syphilis has been revolutionized by the introduction of certain organic arsenic compounds as therapeutic agents. Of these the best known is the German salvarsan, represented in this country by kharsivan, the so-called “606.” Treatment with arsenic has now largely replaced the old method with mercury; but it cannot be carried out except by one having medical training, and so need not be further considered.
Tick Fever.
One of the diseases which may be produced by the bites of insects is a form of fever, conveyed by the bite of a tick, which is common in many parts of Africa. This produces a series of symptoms which are similar to those found in the disease known as relapsing fever, which has been known to occur even in the United Kingdom, and which used to be called “famine fever” (see [p. 218]).
Cause.—The cause is a corkscrew-shaped organism found in the blood, and its vector is the tick above mentioned, which in its adult state and unfed is roughly about the length of a finger-nail, that is, four-tenths of an inch. It is of a greenish brown colour, and is covered by a leathery integument, which looks as if it was spotted all over and which is grooved in several places. When the tick is gorged, these grooves disappear. A gorged female tick may be well over half an inch in length, and very nearly of an equal breadth.
The tick lives in native houses and in rest houses, especially along caravan routes. At night it sallies forth in search of blood, but during the day it conceals itself in cracks and corners in the walls and floors, and sometimes in cracks in native wooden bedsteads. Its bite is painful, but the infection takes place not through the bite, but as a result of the infected excreta of the tick contaminating the tick bite. One tick is sufficient to cause infection.
Symptoms.—The chief symptoms are those of a severe attack of fever, ushered in by a shivering fit and acute symptoms such as are usually found in cases of fever, for example, pains in the back and limbs, rapid pulse, and sometimes severe vomiting and diarrhœa, frontal headache, and painful bloodshot eyes are rather characteristic. The fever, which is of the relapsing type, generally keeps up for about a week, after which there may be an interval without fever for a few days, to be followed later on by another attack of fever. There are usually several relapses. As many as eleven have been noted.