RELAPSING FEVER is one of the three great species of continued fever common in Great Britain, the two others being typhus and typhoid. Although the disease has been accurately described physicians during the last century (since 1739), its present name was given to it only about 1850 by Dr. Benner. It had previously been vaguely known tinder the various names of fire-day frier, sem-day fever, mild yellow fever, short fever, short relapsing fever, etc., and has often ben confounded with common continued fever. It has attracted special notice since 1843-44, when there was prevalent in Scot land "an epidemic fever characterized by the suddenness of its onset, its wide diffusion, its short duration, and its small mortality; by its proneness to relapses, by the frequent occurrence of petechim, of something like black vomit, and of yellowness of the skin; by the absence of intestinal ulcers; and by profuse sweatiugs, whereby the fever seemed to be solved." This fever was supposed :wale time by Alison and other eminent physi cians who described it, to have been a new and hitherto unknown pesqlence; but Jen ner's subsequent researches showed, as has been already mentioned, that in this respect they were in error, epidemics of this kind having previously occurred in Scotland or Ireland (or bold:. simultaneously) in 1736, 1739111, 1800-01, and 1816-20.
Relapsing fever usually begins suddenly with rigors, a sense of chilliness and frontal headache. Febrile reaction soon sets in; the tongue is coated with a thick moist whitish fur; and the sTdu is often so yellow as to approach to jaundice (a phenomenon that never occurs in typhus or typhoid fever). By the fifth or sixth day there is usually delirium. After the al ove-described symptoms have lasted for a period varying from five to eight days. geneislly on the seventh day, a sudden change takes place. This change com mences wiCA a copious perspiration, which is followed by a rapid falling of the pulse to its healthy rate (or even lower), and the patient appears nearly well. But from the fifth
to the eighth day of this seeming convalescence a sudden relapse occurs, and all the primary symptoms return; these run a rather shorter course than before, and again terminate in sweating and in a second convalescence, which is in most cases permanent. The relapse sometimes, however, occurs three or even four times.
Death is a rare termination of relapsing fever, and when it does occur it is usually before the seventh day of the disease. No special anatomical lesion is observed in the 1 o lies of those who succumb to this disease, but enlargement of the spleen is by no means uncommon.
The treatment to be adopted is simple. The bowels should be opened at the com mencement of the attack by calomel and rhubarb, and, if necessary, kept open subse quently with castor oil or saline aperients. The headache must be encountered by leeches or cupping if the patient is robust, and by blisters or dry cupping if he cannot bear the loss of blood. The vomiting is often hard to check: if effervescing draughts fail• it may sometimes he combated by calomel and opium combined in pills.
Its cause is unknown, but it mainly attacks the poor and the ill-housed and ill-fed. Its poison appears to be a specific kind; the phenomena of the fever are very different from those of typhus and typhoid fevers; and persons recovering from these diseases may catch, by et:albite-At, this disease, while patients convalescent fromthis fever may take typhus or typhoid fever. It has been supposed by some physicians to be allied to yellow fever, but it seems more nearly to resemble some form of remittent fever (q.v.). on account of the repetition of the rigors after a regular daily period of from two or three days.