contact with the natives. But, though this and similar facts point to the theoretical possibility of avoiding dengue during an epidemic, in the ordinary conditions of life in the tropics prophylactic measures for the mass are impracticable. Specially delicate individuals, particularly the subjects of tubercular or renal disease, should be isolated, or, better, should leave for a time the epidemic locality.
Like the allied fevers, dengue runs a definite course; therefore it is useless to attempt to cut it short. The patient should go to bed so soon as he feels ill, and he should keep his room till the terminal eruption has quite disappeared and he feels well again. Ten days is not too long to allow in severe attacks. As in influenza, light liquid diet, rest, and the avoidance of chill conduce powerfully to a speedy and sound convalescence. At the outset of the fever some saline diaphoretic mixture, with aconite, may be prescribed with advantage. If the pains be severe and the fever high, antipyrin, or phenacetin, or belladonna will give great relief. Cold applications to the head are comforting. If the temperature rises to 105° F. or over, cold sponging or the cold bath ought to be had recourse to. If the pains continue very distressing, a hypodermic injection of a minute dose (1/10 gr.) of morphia will afford welcome relief and do no harm. Purgatives and emetics should be avoided unless pronounced constipation, or a history of surfeit, urgently demands their exhibition. The pain caused by the muscular movements entailed by the efficient action of purgatives more than counter-balances any advantage the latter might otherwise bring. Wine in the early stage is not advisable. Freshly made lemonade, or iced water, will be found acceptable drinks during the fever.
For the pains experienced during convalescence, rubbing with opium or belladonna liniment, gentle massage, electricity, salicylates, small doses of iodide of potassium and quinine, have been advocated. Debility, or anorexia, indicates tonics such as quinine, strychnine, mineral acids, or vegetable bitters, and change of air.
