Page:Tropical Diseases.djvu/475



Definition and description.— A specific, epidemic, perhaps communicable disease, running its course in from three to six weeks, and characterized by the sudden appearance of anasarca, preceded in most instances by fever, vomiting, diarrhœa, or by irritation of the skin, and often accompanied by a rash, by fever of a mild, remitting type, by disorder of the bowels, and by pronounced anæmia. The case-mortality varies from 2 to 40 per cent., death being sudden and depending upon œdema of the lungs, hydrothorax, hydropericardium, or other pulmonary and cardiac complications.

History and geographical distribution.—The foregoing is a concise description, drawn principally from McLeod's account (Trans. Epidem. Soc. Lond., N.S., vol. xii.) of a disease which appeared in Calcutta, it is believed for the first time, in the cold weather of 1877-78, of 1878-79, and 1879-80. On each occasion it disappeared with the advent of the hot weather. The same, or a similar, disease broke out at Shillong, Assam, 5,000 feet above the level of the sea, in October, 1878; at Dacca in January, 1879; at South Sylhet in the cold weather of 1878-79; and in Mauritius (Lovell and Davidson), having been imported from Calcutta, in November, 1878. There are no trustworthy accounts of its occurrence else- where, although certain vague statements seem to indicate that it appears at times in other parts of India. In Mauritius it prevailed until June, 1879, attacking about one-tenth part of the coolie population, of whom 729 died, a mortality of about 2 or 3 per cent. At Sylhet there were no deaths; at Shillong also the mortality was insignificant; but in Calcutta the death-rate in those attacked was