Prophylaxis.—Avoid sleeping in native huts and rest houses which have been occupied by natives. Do not sleep on the ground or on wooden native bedsteads. If the latter have to be used, their legs should be smoothed to prevent ticks from climbing up them. In badly infested places, it is well to employ a hammock. A mosquito-net is useful, as it excludes the ticks; and it is well to make use of a night-light, which also keeps them away. Packs and blankets should be periodically inspected to see that they do not harbour ticks. If one has to camp on an infected area, the ground should be fired and the floors of huts dug up and thereafter removed and buried or treated with fire, care being taken that the ticks do not escape during the process. Wandering ticks can be kept away from a tent to some extent by digging round it a trench and filling it with wood ashes.
Treatment.—This is mainly symptomatic. Careful nursing is required together with a light diet. In some cases the arsenic preparation known as salvarsan (kharsivan) is found of value, but the specific treatment of this malady can only be carried out by a medical man. In many cases digitalis or strophanthus is required, owing to the risk of heart failure.
Typhus Fever.
This disease is not so common in the tropics, but in certain sub-tropical countries, such as Egypt, it frequently occurs, and it is of course closely associated with military operations in the field.
Cause.—The exact nature of the infection is as yet unknown, but the disease is transmitted by lice, both the head and the body louse having been proved to be carriers of the virus.
Symptoms.—Incubation period 5 to 14 days, as a rule 12 days. Symptoms vary, but at first somewhat resemble those of an influenzal attack without the cold in the head. The patient is feverish and uncomfortable, but not until the third day do the typical symptoms of typhus make their appearance. Then the patient’s face becomes flushed and his eyes congested, his pulse rate increases, and very soon his temperature rises and runs up to 103 or 104° F. The rash, which varies in type, generally appears on the fifth day, being found first on the upper part of the abdomen. It does not occur upon the face, but is usually very profuse on the back. If the rash develops the patient becomes seriously ill, and all his symptoms are intensified. He becomes dull and lethargic, his mouth is foul, and his general aspect is somewhat like that of a drunken man. His voice becomes husky, his hands are tremulous, and his breathing is rapid. In the second week, in most cases, he becomes delirious or comatose, and lies in bed more or less like a log. In cases that recover, improvement sets in about the fourteenth day, and is usually rapid and complete. In cases which die the temperature remains high or rises, the general condition becomes worse, and death usually takes place from heart failure.
Prophylaxis.—Get rid of lice according to the methods detailed on page 196. Those attending typhus patients should be protected from lice by wearing overalls, etc. Patients suffering from typhus should be thoroughly cleansed, their hair cut or shaved, and completely cleared of lice. Bedding and clothing must be disinfected.
Treatment.—Good nursing is of more importance in this disease than the administration of drugs. The mouth must be kept in a good condition, and the food must be strengthening, nourishing soups being indicated. It is important to give the patient as much fresh air as possible, and as a rule he will require stimulants, especially heart tonics such as digitalis or strophanthus. Other measures can be carried out only under medical supervision.
Ulceration of the Throat.
Gargle with a weak antiseptic solution such as permanganate of potash or chinosol. An astringent gargle may be made by dissolving five grains or more of tannin in two ounces of hot water. Sulphate of iron can be used for the same purpose, two grains or more to an ounce of water. If there is much pain, apply poultices to throat.