Treatment.—­Like that for typhoid.  Change climate, if possible.

Beri-beri.—­Beri-beri is a disease rarely occurring in the United States.  It is usually found in the warmer climates and peculiar to certain regions such as India, and Japan.

It is characterized by paralysis and fatal effusion, also neuritis, which is an inflammation of the nerves.  It seems to be undecided among the medical profession as to whether the disease is infectious or not.  Some claim it is brought on by the eating of bad rice or certain raw fish.  Young men in those climates seem to be most susceptible to beri-beri.

Treatment.—­There is very little known about this disease.  Fortunately it does not often occur here.  It is necessary to keep up the strength by food and tonics and relieve the pain.

Anthrax. (Charbon, Wool Sorters’ Disease, Splenic Fever).—­This is “an acute infectious disease of animals, transmitted to man by inoculation into the wounds, or by inhalation of, or swallowing the germs.”  Butchers, tanners and shepherds are most liable to it.  The exciting cause is the bacillus anthracis (anthrax bacillus).  The local skin condition is a pustule containing the bacilli, which may also invade the general circulation.  If the germs are inhaled, there is broncho-pneumonia; if swallowed, areas of inflammation and local death occur in the intestines.  The spleen and lymph nodes are enlarged.

[Infectious diseases 231]

Symptoms. 1.  External anthrax, malignant pustule.  This begins in a papule (pimple) at the point of inoculation turning into a vesicle and then a pustule, (blister-like pimple) surrounded by an inflammatory area (space) with marked watery swelling.  The nearby glands are enlarged and tender.  At first the temperature rapidly rises; later it may be below normal.  The fever symptoms may be severe.  Recovery takes place slowly.  Death occurs in three to five days.

Malignant anthrax (swelling).—­In this lesion is a pustule, with very marked swelling.  It most frequently occurs on the eyelid and face and the swelling may terminate in fatal gangrene.

2.  Internal anthrax.—­(a) Internal anthrax is caused by the introduction of the bacteria into the alimentary canal in infected meat, milk, etc.  The invasion is marked by a chill, followed by moderate fever, vomiting, diarrhea, pain in the back and legs and restlessness.  Sometimes convulsions occur and hemorrhages into the skin from the mucous membranes.  The spleen is swollen.  Prostration is extreme and it often ends in death.

(b) Charbon or Wool Sorter’s disease occurs among those employed in picking over wool or hair of infected animals—­the germs being inhaled or swallowed.  The onset is sudden with a chill, then fever, pain in the back and legs, and severe prostration.  There may be difficulty of breathing and signs of bronchitis, or vomiting and diarrhea.  Death is a common termination, sometimes within a day.  Death rate is from five to twenty-six per cent.  Greatest when the swelling is near the head.