Notebook of Jonathan 'Jack' Tredrea SX18853 - Part 1

PER..474

SX18853

Sgt J. TREDREA

26 RuNDle StReet

Kent Town

S.A. 

Sulpha merazinc
ASI Course for V.D. (Syph)
10 days course.
If suppression of urine
headache
Blood in urine
Stop course give plenty of fluids
& alkaline eg. sod. Bicarb, Sod Cit.
                                              

Leprosy. Course  6%.
½ c.c. twice weekly for
8 doses.
then gradually increase dosage
to maximum of 2½ c.c. dose
Injections subcutaneously. 

Formula for. breaking dosage
down for use in children.
Adult dose X age yrs
                    age +  12
e.g. child 4 yrs. X 2 yrs
grains 10
GRS. X 4
        4 + 12

MALARIA
(A) M.T. Malignant Tertion (treat cures
(B) B.T. Benign Tertian (re-occurs)
Two Cycles  1 Asexual 10 -14 days (in man)
2  Sexual 7-12 days (in mosquito)
Personal Protection. body well covered
use repellant.
Diagnosis
Malaria in 4 stages
1  Premonitary. Like attack of flu.
2  Shivers. Temp about 102^o diarrhoe
cough. pain on joints. urine trouble
3  Sweating. Temp slowly rises
4  Subsides. very slowly
N.B. Enlarging spleen.
Complications.
Coma due to blocking of brain cap
by vast number of parasites laden red
cells. is the most important.

the possibility of occurence of
black water fever.
Malarial Dysentry is actually
caused by the malarial plasmodian      
the intestinal capillaries is
an important complication often
overlooked.
The onset is sudden & is
accompanied by pyrexia & a rigor
and it may be by vomitting during
the course the patient is seized
by violent abdominal pains & passes
stools composed of blood clots
& bright blood stained mucus
The stools may not exceed 6 in 24 hrs
Treatment 8 days
consists of Quinine gr. 10 2.TOS 3 days
Atebrin 6 5 4 3 2 1.
Gastric Malaria If patient vomits
keep repeating every half hour.

Black Water Fever
Is associated with inadequately
treated malaria. It is entirely
distinct in its pathological nature
and from a malaria attack but
malarial infection is an essential
factor in its causation.
Distribution
It is found wherever there are
hyperendemic foci of malaria and in
such places M.T. infection is always
predominant
Symptoms 1 Malarial shivers. chill
though more severe. Attack may be
sudden
2 Feel out of sorts for some days
3  Conjunctivae has yellow tinge
4  Shiver headaches lumber pain
vomitting of bile often suffer
with epigastric or hypogastric pains

5  Temp mounts rapidly passes dark
urine varying in colour from reddish
hue to dark coffee colour & has
heavy deposit.
6  Liver & spleen enlarges, Skin hot
and dry & turns a jaundice tint
rapidly deepening
7 rapid pulse soon weakens
8 Bad cases high fever mental
derangement vomitting, hiccups
profuse diarrhoea
Treatment
Plenty of fluids of any type &
also tabs sodu Bicarb 4 every
4 hours for 24 hours evacuate as
soon as able
Patient must not be moved
during critical period build 

shelter over him.

Dysentry Two Types
A) Bacillary. Fast type 7 days
B) Amoebic. slower type 1 - 3 months
disease starts 7 days after infection.
Symptoms
1/ Griping pains in the right & left
illiac fossac often severe & motion
contains blood & mucus & such
passage is associated with straining
When disease is established there
are between 10-15 motions in 24
hours Dark fluid blood & mucus
Blood not as bright as Bacillary
dysentry.
2/  No fever as a rule but nausea
& vomitting.
3/  Bacillary Dysentry Bluish red
flush on cheeks

4/  attack of pain in stomach
later becomes worse.
5/  Stool fluid pussy like red jelly
6/  May have vomitting with blood

& blood in urine.
7/  Discomfort about anus.
Treatment for Baccillary 
Fluids (no milk) Sulphaguarnadine
Initial dose of 16 tabs then 8 tabs
4 hourly for 3 days.
Then 4 hours later. 8 tabs  6 Am
"     10 "
"      2 Pm
"      6 Pm
"     10 "
"     2 am
8 tabs B.D. per day for 2 days
Morphia may be given to relieve
pain.
Full course 168 tabs for 5 days.

Treatment, Carbosone
1 daily for 10 days.
Treat all diarrheoa as dystentry
& give full course & only cease
when condition has become
normal.
Amoebic Dysentry starts at
least one month after infection
before it starts Diarrhoea stools
will be brownish not red as
in bacillary not very fluid
Stools have foul odour
If diarrhoea is still bad after
treatment of bacillary its
either infective or Amoebic
very little fever.
Treatment
Emetine Hydrochloride gr. 1 per
day for 12 days Injected
intravenously or intramuscular-
either full dose or two ½ gr dose

Emetine Bismuth Iodine gr 3 capsule
give 12 days may cause vomitting

Scrub Typhus
Also known as coastal fever or
Jap river fever caused by Makkas
on ticks. Red tick normally
lives on animals in the jungle
rodents dogs etc. about the ear.
Remove tick by hot needle or
forceps.
Symptoms
Rash caused by itch.like
scabies, from tick bite. About
3 weeks later papual forms with
black centre, 70% in waistline
8 days later gland nearest papual
gets enlarged patient gets gradually
sick. later delirious & rash starts
with coughing patient refuses food
gets bad headaches
Complication pneumonia or heart
failure affects heart urine & lung

Treatment.
1/  Absolute rest & quietness
2/  Sulphur ointment. 3 days rest a
week then reapply
3/  Clean clothes
4/  Delirious (sedative 1 gr phenobarb)
5/  Pneumonia - to stop give aspirin
and course of ASI treatment
Prevention
Use fluid anti mite on clothing
and a application [[?]] inspect
body daily

                                              
Cholera.
Is a vomitting & diarrhoea disease.
Symptoms
Incubation from 6 hours to 6 days
or even longer.
Stools frequent watery rice
water colour but painless
 

Vomitting stage is acute &
explosive but no nausea
or abdominal pain
The muscular cramp & urine
stopping cramps of legs &
abdomen.
Eyes sunken nose pinched skin
cold & dusky in hue pulse feeble
& urine less. Hiccups may be
obstinate & persistent.
The serious stage becomes
intensified the skin of the
fingers shrivels. Voice husky
the body surface is cold with
a clammy sweat. pulse almost
vanishes, kidney ceases to act
patient is restless & thirsty, the
mind is clear but the patient 
is apathetic.
 

Treatment
1/  Treat for shock
2/  Plenty of fluid before
dehydration sets in.
3/  plenty of salt
4/  Morphia to rest bowels ½ gr.
or morphia & atropine ^∧1/6/ & 1/100 intramuscular
5/  Treat cramp with hot bottle
& massage.

                                             
Rat Plague Fever
follows the bite of rats.
The bite usually heals normally
in the first instance but after
a variable period from a week
to months the scar becomes
swollen glands enlarged and
tender at the same time
Chilliness headaches & often pain
 

in the joints & muscles.
Temp rises to 102° to 104° and
with this a wide spread purplish
eruption of wider s.
Treatment
Response to arsphenamine
compounds is very satisfactory
2 injections normally brings
about a cure.

                                         
Plague  occurs in all areas
above 3000' carried by bites
from rats. fleas, keep away
from native villages.
3 types
1/  Bubonic plague, glands
mostly involved
2/  Septicaemia. organism in
blood streams
 

3/  Pneumonic - in lungs.
Incubation period 2-10 days.
pains mental weariness shivers
followed by sudden shivers &
the fever. Severe headache backache
rapid pulse & respiration.
Red eyes restlessness giddiness
and prostation. Patient has
expression of fear on face.
In Bubonic the common
main feature is enlarged glands
surrounded by soggy swollen
tissues. In 70% groin is
troubled 20% armpit Glands
supurate on 2nd weeks & are
pussy and foul smelling. Tongue
is very great & pulse becoming
poor & intermittent.
 

In Septicaemia prostration
is extreme delirium coma &
then death.
In Pneumonic which occurs
in colder climates sputum is
watery prune juice colour &
is freely expectorated. It
is highly infectious death
occurs on 3rd or 4th day.
Always use mask when handling
the patients.
Treatment
Anti plague serum early
in large doses or course
of ASI and plenty of fluids
                                      

Rabies (Hydrophobia)
Symptoms in dog.
Is similar to those that occurs
in the man. The course of
the disease from the time when
the symptoms commence, lasts
not more than 5 days and 

during this period there are
three stages.
1st stage  altered behaviour
The dog seeks secluded corners
ceases to be obedient and may
show access of affection
Perverted appetite this is one
of the most characteristic feature
of the disease in the lower animal.
2nd stage
Excitement aggression, snapping
unprovoked biting - aimless
 

wandering and alteration of
barking to high pitched tone.
Staggering gait panting outpouring
of saliva. This lasts 1-3 days.
3rd Stage
Stage of paralysis lifeless
hanging tail the animal
sits on its hind quarters
and barks with high pitched
tone. saliva dripping from
its mouth.
Disease in Man
The incubation period is
variable. The closer the bite
is to the brain the shorter
will be the incubation period
Face bite  30 days
Arm     "     40 days
Leg      "      60 days