Notice to ships' surgeons : suggestions for the prevention, diagnosis and treatment of malaria / [Ministry of Transport].

  • Great Britain. Ministry of Transport
Date:
[1949]
Catalogue details

Licence: Public Domain Mark

Credit: Notice to ships' surgeons : suggestions for the prevention, diagnosis and treatment of malaria / [Ministry of Transport]. Source: Wellcome Collection.

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    collapse, especially if hyperpyrexia has been present. Copious alkaline drinks (lemon-squash, barley-water, soda, etc.) with plenty of sugar should be given. As a rule avoid anti-pyretics. For severe headache, aspirin or phenacetin can be taken, but the latter drug should always be combined with caffeine to counteract any tendency to heart failure. (c) During the Sweating Stage.—The patient’s clothing and bedclothes should be changed frequently. Watch for collapse, and if signs of blueness or feeble pulse are observed, stimulants should be given. (iv) Restless cases should be nursed on the ground to avoid injury. _ Care should be taken that in restraining such cases the spleen is not ruptured. In very violent cases it may be necessary to give sedatives— morphia or barbiturates. Retention of the urine should be watched for in comatose cases. (v) During the attack a light fluid diet should be given but the patient must not be starved. Citrated milk is useful during the febrile stage ; fats should be avoided at all stages, and meat given but sparingly or not at all. Plenty of carbohydrates, especially sugar, help to protect the liver; while an abundance of green vegetables and fruit (oranges, tomatoes, apples, pineapples, etc.) are useful in increasing the alkali reserve. The patient should be made to take large quantities of sweetened alkaline drinks at all stages. If alcohol be given, it should be in modera- tion, preferably not spirits. (vi) Patients who have lost much fluid by perspiration, vomiting and diarrhoea, should be given salt to replace that lost. In choleraic cases, it may be necessary to give intravenous injections of physiological (or even hypertonic) saline solutions, or of glucose-saline solutions by intermittent or by continuous drip methods. B. During Convalescence. _ During the convalescence, a nutritious diet should be insisted on. This should contain good biological proteins, adequate vitamins especially B. and iron. (Red meat, bread reinforced with wheat germ or rice polishings, fresh and dried fruit, such as peaches and apricots, are of special value.) Any secondary anaemia is treated with iron, arsenic and liver therapy, if severe (vide infra). (7) THE SPECIFIC TREATMENT OF AN ACUTE ATTACK OF MALARIA. - This should be started immediately a diagnosis of malaria has been made, because attacks of malignant tertian malaria may develop serious pernicious symptoms with little warning and the life of the patient may depend upon early and vigorous treatment. I. Anti-Malarial Drugs. The drugs of value in controlling and curing the acute clinical attacks of malaria are quinine, “‘ Paludrine’’ and mepacrine. The effects of these drugs in diminishing the relapse rate and in hindering the spread of