In 1980, an outbreak of a mild illness involving twenty pupils and four adults in a boys' boarding school was identified serologically as psittacosis. Intensive epidemiological investigations did not uncover the source. It is suggested either that sources of chlamydia other than avian exist, which may produce a milder illness than the avian type, or that human-to-human spread of a mild form of chlamydiosis occurs.
AmRr more than ten years' experience of the treatment of many thousands of cases of malaria in Uganda, the results I have obtned with smaal doses of quinine have led me to conelusis so different from toe expressed recently in your columns that I hope they may be wortl recording.Mlost of the cases of malaria met with in Uganda are simple subtertian without complications, and the routine treatment I adopted for these was as follows:1 As compared with other purgatives, a dose of calomel (5 grains) at the commencement of an attack of malatia appears to have an almost specific action in preparing tile way for the quinine, and to it I attribute to a very large extent the absence of complications and quick responise to quinine.With blackwater fever my experience is that if tine 5 grains of calomel can be given immediately an attack begins no s4erious complications arise, and,.with careful general treatment, blackwater fever is removed from the category of the most dangerous diseases. I have had onjly two deaths among my patients from blackwater fever. 1n each case I was able to see the patient for the first timle only on the third day of the attack; one patient had taken 2 grains of calomel, and had been on and off the stool all night with great pain and discomfott, but with so little result that several sap and. water enemata were needed before a saline injection could be mae into the rectum. In the scond fatal-case no purgative at all had been given.Blackwater fever, however, is, in my opinion, a complication of malaria which should rarely if ever occur. It appears to be the result of a final and drastic effort on tlje part of nature to eliminate the parasites from the body, usually after several untreated or insufficiently treated attacks of malaria. I have seen no case of blackwater fever occur during the treatment of malaria if both calomel and quinine had been given, but I have seen cases, usually slight, after quinine alone. In these, to my mind, tile question has not been whether the quinine brought on tlje attack, but how much more serious the attack would have been if no quinine had bee given.With regard to large doses of quinine it may be of interest to record that during the war sveral cases of malaria were sent up to Uganda from Mombasa to try tl1e' effects of a change of air. Some of these whom I saw at Entebbe informed me that they had been taking 40 to 60 grains of quinine daily for several weeks without tlle temperature remaining normal for twenty-four hours. With most of these complete stoppage of the quinine brought the temperature to normnal within three days. In one case the temperature came to normal and remained normal until the eighth day, when it again went up to 1030 F. Subtertian parasites were then found in the blood, and treatment -with calomel and quiniine as described above was commenced. In tAhree days the temperature was again normal, and there had been no recurrence of tlle fever when I last beard of the patient three weeks later.
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