ng the
finger before the blood returns to the pressure spot. With fall of
fever, and abatement of symptoms after two or three days, the patient,
instead of going on to recovery may, after a few hours or a day or
two, again become very feverish and have vomiting--perhaps of blood or
black vomit--yellow skin, feeble pulse, failure of kidney action with
suppression of urine, delirium, convulsions, stupor, and death; or may
begin to again recover after a few days. Mild fever, slight jaundice,
and absence of bleeding are favorable signs; black vomit, high fever,
and passage of little urine are unfavorable signs. The death rate is
very variable in different epidemics and among different classes;
anywhere from fifteen to eighty-five per cent. Among the better
classes it is often not greater than ten per cent in private practice.
Heavy drinkers and those living in unfavorable surroundings are apt to
succumb.

=Prevention.=--Yellow fever, like malaria, is a preventable disease,
and will one day be only a matter of historic interest. Dr. W. C.
Gorgas, U. S. A., during 1901, by ridding Havana of the mosquito
carrying the yellow-fever organism through screening barrels and
receptacles holding water, and by treating drains, cesspools, etc.,
with kerosene, succeeded in also eradicating yellow fever from that
city, so that in the following year there was not one death from this
disease; whereas, before this time, the average yearly mortality had
been 751 deaths in Havana. Spread of the disease is controlled by
preventing access of mosquitoes to the bodies of living or dead
yellow-fever patients; while personal freedom from yellow fever may be
secured by avoiding mosquito bites, through protection by screens
indoors, and covering exposed parts of the face, hands, and ankles
with oil of pennyroyal or spirit of camphor, while outdoors.

=Treatment.=--There is unfortunately no special cure known for yellow
fever such as we possess in malaria. The patient should be well
covered and surrounded with hot-water bags during chill. It is
advisable to give a couple of compound cathartic pills or a
tablespoonful of castor oil at the start. Two, or at most three,
ten-grain doses of phenacetin at three hours intervals will relieve
the pain during the early stage. Cracked ice given frequently by the
mouth and the application of a mustard paper or paste (one part
mustard, three parts flour, mixed with warm water and applied between
two layers of th