By P. B. Bhattacharya. Second Edition. Revised, Re-written, Enlarged and Brought Up to Date. By J. C. Banerjea, M.B. (Cal.), M.R.C.P. (Lond.) and P. B. Bhattacharya, M.B., D.T.M. (Cal.). Bengal Medical Service, Upper. Pp. I–X. 1–413. U. N Dhur & Co., Calcutta. 1938
Fermentative disturbances of the digestive tract with complaints of acidity and burning in the epigastrium, esophagus, and frequently the mouth, accompanied by loss of weight and strength, are by far the most common gastro-intestinal vagaries seen in Porto Rico.
Loss of weight is only moderate but loss of appetite is considerable, with constipation broken at intervals by short periods of loose bowels. Indefinite nervous symptoms, such as mental irritability and depression, restless nights, vague muscle pains, cramps in the legs, numbness of the extremities, and palpitation of the heart are constant by-products. The skin becomes dry and bronzed in patches, especially over malar prominences, forehead, neck, back, and extensor surfaces of the arms. The temperature is apt to be subnormal and the blood pressure low, with a light grade of secondary anemia.