RELAPSING FEVER (also known as FAMINE FEVER and SEVEN-DAY FEVER), one of the three great species of con tinued fever, the two others being typhus and typhoid. It was first definitely dis criminated from these diseases by Dr. Henderson of Edinburgh and other Scotch physicians about 1842. During the 19th century it was met with in Ire land, Scotland, England, in central and eastern Europe, the countries surround ing the Levant, north Africa, India, China, and, though never extensively, in North America. Relapsing fever usu ally begins suddenly with rigors, a sense of chilliness, and frontal headache. There is severe aching pain in the joints and muscles, and great sleeplessness; but delirium, if present at all, usually comes on only toward the end of the first week. After the above-described symptoms have lasted for a period varying from five to eight days, generally on the seventh day a sudden change takes place. This crisis commences with a copious perspiration, which is followed by a rapid falling of the pulse and temperature to or below the normal, 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 pri mary symptoms return; these often run a rather shorter course than before, and again terminate in sweating and in a i second convalescence, which is in most cases permanent. The relapse some
times, however, occurs three or even four times. Death is a rare termina tion of relapsing fever; except enlarge ment of the spleen. One form of the disease, however, is much more severe, and very often fatal. It was originally described as a distinct disease under th_q name of bilious typhoid, and is character ized by more marked implication of the digestive organs, by the constant pres ence of jaundice, and by absence or in complete development of the crisis and intermission. It has now been shown to be really identical with relapsing fever proper. Relapsing fever is generally met with among those living under un favorable hygienic conditions; it is spe cially apt to attack a population suffer ing from insufficient nourishment (hence the name famine fever), and is seldom met with among the upper classes, or among Europeans residing in the tropics, unless they are brought closely in con tact with the sick. At the same time it is very infectious, spreading either directly from the patient to doctors, nurses, etc., or from clothes and bedding to washerwomen, who have suffered se verely in some epidemics.