Page:Tropical Diseases.djvu/967



AN acute and very fatal condition locally termed " the vomiting sickness " has been known for many years in Jamaica. It is found principally in rural districts and occurring in what were regarded as circumscribed epidemics. Until quite recently its causation and nature were neither apprehended nor understood, although several Commissions had attempted their elucidation. To Dr. Harold Scott belongs the merit of clearing up the mystery, and indicating simple and practicable methods of prevention, which, if given effect to, must avert a considerable mortality, particularly among children. The vomiting sickness is confined to the West India Islands, and practically to Jamaica, and occurs principally during the cooler months November to April. Symptoms.— A previously healthy child suddenly complains of abdominal discomfort, vomits several times, and apparently recovers, perhaps falling asleep. Three or four hours later, vomiting— now of a cerebral type— recurs. Within a very short time, a few minutes perhaps, convulsions and coma supervene, and death follows on an average about twelve hours from the oncoming of the initial vomiting. The case-mortality amounts to 80-90 per cent. In those who recover, convalescence is complete in twenty-four hours.

During the attack the temperature is normal or subnormal, rarely rising to 101°; the pulse is 90 to 100; the respirations are 26 to 30, sometimes, as death