5 J. Christie, "Remarks on Kidniga Pepo, a peculiar form of exanthematous disease epidemic in Zanzibar, East Coast of Africa, from July, 1870, to January, 1871," Brit. Med. Journal, July 1, 1872, p. 577 (reported in Virchow und Hirsch's Jahresbericht für das Jahr 1872, vol. ii. p. 203).
6 Virchow und Hirsch's Jahresbericht für das Jahr 1873, vol. ii. p. 208.
Finally, in 1880, dengue, in the form of a very extensive epidemic, prevailed once more along the Southern coast, visiting equally Charleston, Savannah, and New Orleans. A number of valuable observations concerning the nature and symptoms of the disease were made during this epidemic by Drs. D. C. Holliday of New Orleans, J. G. Thomas of Savannah, and F. T. Porcher and J. Forrest of Charleston.7 At the same time it prevailed at Alexandria8 (Egypt) to such an extent as to affect nearly the whole population.
7 The papers of Drs. Holliday, Thomas, and Porcher were read before the American Public Health Association at its annual meeting, December, 1880, and published in the Proceedings of the Association. Dr. Forrest's paper was published in the American Journal of Med. Science, April, 1881.
8 A. Vernoni, "Le Dengue à Alexandrie d'Égypte en 1880," Gaz. hebd. de méd. et de chir., 41, 42 (reported in Virchow und Hirsch's Jahresbericht für das Jahr 1880, vol. ii. p. 5).
Dengue has been known under various popular names which it received from the people of the particular localities where it appeared in epidemic form. Even the designation, dengue, itself, by which the disease is at present generally known to the medical profession of the leading civilized nations, is of popular origin,9 for it is supposed to be a Spanish corruption of the word dandy, the name of dandy-fever having been jocosely conferred on the disease by the negroes of St. Thomas from the stiff carriage of those affected with it. At Zanzibar it received the popular name of kidniga pepo, signifying spasmodic pains.
9 G. B. Wood, Practice of Medicine, 4th edit., vol. i. p. 444.
DEFINITION.—Dengue is a peculiar febrile disease, generally appearing epidemically in tropical or semi-tropical regions, and characterized by a single paroxysm with or without remissions, severe pains, and stiffness in the joints and muscles, a peculiar exanthematous eruption, and almost never terminating fatally.
SYMPTOMS, COURSE, AND DURATION.10—Dengue never commences with a decided chill, though in many cases the attack of the disease is preceded by a feeling of general uneasiness and depression, vertigo, and headache, or even by a slight chilliness—a condition which may last from a few to twelve or even eighteen hours. In the majority of cases, however, the disease appears suddenly, very frequently at night, and announces itself at once by pains and a feeling of stiffness in the muscles, joints, back, and loins; in severe cases the pain may even extend to the bones.11 The larger and smaller joints are equally affected, either simultaneously or successively, and frequently swollen, those of the hands and feet generally before the others. The pain in the joints is increased by motion, and is therefore justly regarded by most authors as rheumatic in nature. The same may be said of the muscles. Sheriff even observed redness of the skin covering the joints. According to the degree of severity of the case these pains may be more or less intense. In some cases hyperæsthesia of the skin of the palms of the hands and of the soles of the feet has been observed.
10 Judging from the various accounts rendered by a considerable number of observers, it appears that the clinical symptoms of dengue had been the same in all the different localities on the globe where it has hitherto prevailed epidemically.