Cold, it is said, tends to repress the development of the eruption; until this appears, fever and pain persist. For this reason, as well as to avoid the hæmorrhage from the lesions when they do erupt, the patients should quit the heights and descend to near the sea-level. External hæmorrhages, when they occur, must be treated by graduated pressure; otherwise the local as well as the general treatment is the same as for yaws.
Where possible, workmen in endemic districts should quit the locality before sunset. On a certain railway running through the endemic zone, on which the mortality from this disease was enormous, by Dr. Giana's advice the workmen were obliged to quit the locality before sunset; the case-incidence immediately diminished.
NOTE. Since the foregoing was written Strong has published (New York Med. Journ., March, 1914) the results of his investigations on this disease in Peru. He comes to the conclusion that Oroya fever and verruga Peruana are two distinct diseases, the former produced by a special bacillus, the germ of the latter being still unknown. He succeeded in conveying verruga Peruana to monkeys.
