REMITTENT FEVER, one of the va rieties of fever arising from malaria or marsh poison—one being intermittent fever, or ague. In its milder forms it scarcely differs from severe intermittent fever; while in its more serious form it may approximate closely to yellow fever. The attack may be either sudden or pre ceded by languor, chilliness, and a gel eral feeling of illness. Then comes A cold stage, usually of short duration. This is followed by a hot stage, in which the symptoms are commonly far more intense than those exhibited in the worst forms of ague. Giddiness proceeding to delirium is not uncommon, and is a bad symptom; w,hile in other cases drowsi ness or lethargy is one of the most marked symptoms. There is often great tenderness or pain in the region of the stomach, and vomiting—the vomited matter frequently containing bile or blood. A remission of these symptoms occurs, in mild cases, in six or seven hours; but in severe cases the paroxysm may continue for 24 hours or longer. The remission is sometimes, but not al ways, accompanied with sweating. The duration of the remission is as varied as that of the paroxysm, varying from 2 or 3 to 30 hours, or even longer. The fever then returns with increased severity, and without any cold stage; and then the paroxysms and remissions proceed, most commonly according to no recognizable law, till the case terminates either fatally or in convalescence. In favorable eases convalescence is usually estab lished in about a week. The severe
forms of this fever are often accom panied with more or less jaundice, and hence the disease has received the name of bilious remittent fever. It is also known as jungle fever, lake fever (from its prevalence on the border of the great African lakes) ; and the African, Bengal, Levant, Walcheren, and other similar local fevers are merely synonyms of this disease. In England the disease is very rare; and when it occurs it is usually mild. The disease is most severe in southern Asia, western Africa, central America, and the West India Islands.
The first object of treatment is to re duce the circulation during the hot stage. This is done by a dose of fr_ e grains each of calomel and James' powder and after an interval of three or four hours, by a sharp cathartic—as, for instance, the ordinary black draught. On the morning of the following day the remis sion will probably be more complete, when quinine should be freely and re peatedly administered. A mixture of antimonial wine with acetate of potash should also be given every two or three hours, so as to increase the action of the skin and kidneys. The patient must be carefully watched during the period of convalesence. A timely removal from all malarious influence, by a change of climate or a sea voyage, is of the highest importance.