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Malarial Fevers

fever, attack, ague, cold, stage, attacks and poison

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MALARIAL FEVERS.

(See Plate XXX.) Ague (Intermittent Fever—Mara,, Fever Malaria).—Ague or intermittent fever is not' a disease that may be communicated from one person to another. It is nevertheless a fever' which is due to the introduction of some poi sonous agent into the blood. That the poison ous agent is a living organism was first shown by an Italian observer, Laveran, but the credit of proving that the organism was introduced into the blood of the human being by the bite of an infected mosquito, of the genus Anopheles, belongs to an officer of the Indian Medical Service, Major Ronald Ross. Major Ross has shown that this kind of mosquito breeds in shallow puddles of water, not large enough to contain minnows or water-beetles, and not so small as to dry up quickly, in hollows of rocks left full of water by drying water-courses after rains, in badly-made drains and gutters and small pools containing green mould or water-weed, in disused wells, garden cisterns, water-butts, and so on. He has shown that in proportion as such things are drained or cleared out or filled up in malaria infected settlements, the number of mosquitoes diminishes and the amount of malaria with them. Mosquitoes may also be destroyed in their breeding-places by pouring on petroleum oily paraffin, or kerosene, or creasote, in suffi cient quantity to make a thin film on the surface ; and it appears that systematically dealing with such breeding-places in the road ways, back-yards, and immediate neighbour hood of houses of malaria-infected settlements and towns would in time clear them of mos quitoes and of infection.

Individuals will not suffer from malaria if they protect themselves from mosquito bites. This they may do by the use of appropriate gauze veils, by keeping the insects out of the houses 'by wire screens, by sleeping within mosquito curtains, and by similar means.

One attack of ague, instead of protecting against a second, renders a person more liable to renewed attacks from the least exposure to the poison. Moreover, one who has suffered from ague is liable to other attacks even with out being again exposed to the action of malaria.

Fever may appear in persons within a day or two after the reception of the poison, while others may have been removed for months from the malarious district before evidence of their having become affected by the poison presents itself.

feature that marks marsh fevers is that there are several attacks of fever separated from one another by intervals, during which the sufferer appears comparatively well. In its progress the fever has three well-marked stages : the cold stage, the hot stage, and the sweating stage, following which is the period of the intermission, as it is called, in which the fever is completely absent. This period lasts for a variable time, and is succeeded by a second attack of the fever, going through the same stages as the first, ending in an intermission, followed by another attack, and so on. In one case the interval between the beginning of the first attack and the beginning of the second is only twenty-four hours. There is, iu this case, a renewed attack of fever daily. This form is called quotidian ague. In another form, from the commencement of the first attack to that of the second is forty-eight hours. That is to say, there is a renewal of the fever every other day. This is called tertian ague. In a third form, the fever is renewed the third day from the beginning of the previous attack. This is quartan ague. In other cases the fever re turns every fourth, fifth, or sixth day.

For some time before the disease actually attacks, the person may complain of wearied ness, loss of appetite, headache, and pain in the back, or the disease may suddenly.

The cold stage is marked by a feeling of cold ness; the person shivers ; his teeth chatter and his limbs tremble violently ; the face and hands are blue with the cold ; and the skin is shri velled and presents the appearance of " goose skin ". There is uneasiness about the stomach; headache and pains in back and limbs are present. Much very clear water is passed, and frequently. This stage may last from half all hour to several hours. The cold is only appa rent, for if the temperature be taken with the thermometer (p. 38) it will be found already above the usual height.

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