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To the average North American physician, unless he be located in Mexico or in one of the extreme southern states, "breakbone fever" is so rare a disease that a case of it would probably pass unrecognized. The practitioner in the tropics, however, usually receives an early introduction to the affection and the acquaintance becomes in time an intimate one.
Persons who have previously resided in a cold or temperate climate appear to be especially susceptible to the infection, and it is for this reason that it is so prevalent among fresh drafts of men sent into warmer climates for duty.
It is not my intention to take up a general discussion of the disease here, such information being readily obtainable from any standard work on tropical medicine. The type usually encountered in Central America, however, I am informed by competent authorities, differs so much from
SUTTON RL. DENGUE IN THE ISTHMIAN CANAL ZONE.A PRELIMINARY REPORT.. JAMA. 1904;XLIII(25):1869-1871. doi:10.1001/jama.1904.92500250002k