'Military Report on South-West Persia, Including the Provinces of Khuzistan (Arabistan), Luristan, and Part of Fars' [‎66] (101/466)

66
paroxysm of fever is not apparent. The symptoms which are thus seen
co-existent with a subfebrile state are pallor, if not yellowness of skin and
coniunctiva, nausea, loss of appetite, severe headache, lassitude, nervous irri
tability pain over the whole body, high-colored urine, with copious deposit,
and not unfrequently slight cough, all of which disappear quickly by the
use of a few doses of quinine. _
This prevalence of a mild type of malarious tever is due, 1 believe, to
the operation of the balance of malarial virus left after ^ the pure north-west
breeze has exerted its benign influence in the neutralization of the quantity of
poison engendered by the action of heat on the organic matter on and in the
surface o£ the plain immediately beyond the walls of the city. Of course this
balance is increased during southerly winds; but fortunately these do not
last long.
We find the greatest prevalence of this sickness m the months of March
and April before the hot weather, and October and November at the begin-
nino* of the cold. This is, as might be expected, the greatest diurnal thermo-
metric range occurring at these periods.
I imagine the coincidence of an increase of intermittents witli the
greatest diurnal range of temperature to be brought about as ft)llows 4
Wherever malarial poison exists, every one in the vicinity must inhale more
or less, and are affected with fever or not just as the individual is starving
with cold or hunger, or well fed and properly clothed, and in a relative degree.
But when the temperature is for some time subject only to an ordinary and re
gular variation, the skin and lungs (especially the former), by virtue of their
excretory function, are enabled to throw off nearly, if not all, the poison.
When, however, a marked thermometric subsidence takes place, the cutane
ous muscles are forced to contract, closing the orifices of the sudoriparous
glands, the exit of the poison from the body thus becoming suppressed,
necessitating an effort on the part of nature to get rid of it. This effort
takes the shape of a paroxysm of fever, and the increased transpiration
consequent thereon seems to be the medium of the expulsion of the poison.
The enlarged spleens which results from repeated attacks of this fever
I have treated with strong mercurial inunction in accordance with the practice
and teaching of Dr. Maclean of Netley, but not hitherto, for some reason or
other, with the success I had been led to anticipate as regards the reduction of
the enlargement.
Of eye diseases,*" there have been upwards of three hundred in attendance.
Conjunctivities heads the list, and calls for no remark,
Eye diseases. except that I have found snipping out a minute portion
of the injected conjunctiva a speedy means of arresting and causing a rapid
resolution of the inflammation.
Opacities of the cornea have been rather numerous. About one-nalr or
this class required no operative interference. Of the remainder 50 per cent,
or thereabout were beyond benefit from the making of an artificial pup
owing to the extent of the opacity. Of the rest, twenty-two underwent the
operation for artificial pupil, a satisfactory result following each, with the
exception of one, the case of an old pauper, where, from the debility of the
patient, a haze surrounded the resultant cicatrix of the wound made by tne
entrance of the keratome at the sclero-corneal junction.
* Ophthalmia is very prevalent in Shustar and Dizful. Causes of eye diseases are—(l^wa^nt of
cleanliness; (2) insufficient protection from the sun's rays; (3) contagion; (4) overcrowding;!/
duststorms {see page 38).