Page:The Journal of Tropical Medicine, volume 6.djvu/224

192 THE JOURNAL OF TROPICAL MEDICINE.

bowls a day. He is allowed nothing else till the tem- perature has been normal for a week. Strange to say, the patient never objects to the condensed milk.

Relapses are less common and usually the recovery is more complete and speedy than at home; but in a few cases weakness both of body and mind persists for a few months after the fever is well.

I have met with one case of what has been termed ‘“paratyphoid fever.” In this case the clinical symp- toms were typical of a moderately severe attack of typhoid, but Widal’s reaction was negative. The patient recovered.

To sum up: Typhoid fever is a disease which is endemic amongst the natives of this region; in its general signs and symptoms it conforms to the disease met with in Kurope, and at the present time is attended by a not insignificant death-rate. The name typho- malarial fever is a misnomer which should be at once dropped, there being no specific fever of this type.

I have said nothing in this paper of the relation between double continued fever and typhoid, as I have only had the opportunity of closely studying one case, but it may be stated that malarial plasmodia were absent, Widal’s reaction was decidedly negative, and the clinical symptoms were not those of typhoid fever.

TROPICAL HYGIENE. By W. J. Simpson, M.D., F.R.C.P.

Lecture III.—Continued. Water Supplies. (Continued from p. 174.)

The Marche Automatic Water Steriliser is an appar- atus somewhat on the same principle as the Forbes Water Steriliser, but not nearly so portable. It is useful, however, for hospitals and institutions in which it is desirable to purify the drinking and domestic water supply. A few of them were supplied in South Africa during the recent campaign. Fig. | is a sketch of Maiche’s Steriliser, made use of in the Fort of Pieter- maritzburg during the war, and which supplied 800 gallons a day of sterilised water to the married quar- ters. The steriliser was placed in a small closed tower, which was formerly used for stores. On the roof of the tower was a water tank, supplied with unpurified water, which was conveyed by a pipe through the roof to the cylinder of the steriliser in the tower. The cylinder being longitudinally chambered, the water flowed through one of the chambers, and was then conveyed to the vessel in which the water was heated by a kerosene lamp. The heated water was then conducted back to the top of the cylinder, and in passing down in a small spiral pipe lost its heat to the incoming water, so that on leaving the cylinder and reaching the receiving tank the water was cool and fit for drinking. From the receiv- ing tank in the tower the sterilised water was conveyed by a pipe to a 400-gallon tank situated at a convenient place in the fort, where it could be drawn off by taps as required, The initial cost of the steriliser was £56,

[June 15, 1903.

and in constant use it consumed five gallons of kerosene a week. The maintenance cost about 9d. a day for 800 to 1,000 gallons a day. The oil lamp was required to be filled night and morning. The door was then locked, and the steriliser was left to work automatically. A part of the apparatus is a valve in front of the steri- liser, which regulates the flow according to the tempera- ture attained; the higher the temperature the quicker being the flow, and the lower the temperature the slower the fiow. If the temperature falls below 212° the flow stops until the temperature rises. The valve requires very little attention. having in this case only been regulated once in six months.

p—yue] Woy Blanket_wrapping around pipes Top covered = with Blanket wrapped with caNvas ty R a Reducing Piece

Fia. 1.—Sketch of ‘ Steriliser.”

Like the Forbes Steriliser, the Maiche retains the al of the water in solution, and accordingly the insipid taste that belongs to boiled water is wanting.

afterwards allowing the water to cool. This method can be used on a large scale, and is adapted to large works where there is plenty of steam. a

Filtration. — Purification of water by filtration 18 adopted on a large scale for communities, and on a

Where | neither of these apparatuses is at hand, but where steam is available, water may be sterilised in iron tanks by conveying the steam by pipe to the tanks and them