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Malaria Intermittent

fever, mosquitoes, attacks, days, disease, time, intervals and diastase

MALARIA (INTERMITTENT FEVER).—.1 febrile affection characterised by alternating attacks of fever, chills, muscular pains, and perspiration. It is of quite frequent occurrence in southern Europe, the United States, and particularly in the tropics. In the northern and central parts oI Europe it occurs only in isolated places. In the tropics malaria causes a great deal of sickness among Europeans ; and upon the prevalence of this disease depends the healthfulness or unhealthfulness of a district. The disease is caused by micro-organisms belong to the lowest animal group (Protozoa). These organisms enter especially the red blood-cells and destroy them. The infection is transmitted from one person to another by certain varieties of mosquitoes. When a mosquito has sucked blood from a patient affected with malaria the parasites enter the insect's body, where they undergo a certain development ; after a number of days the mosquito may bite a healthy person and transmit the microbes with the bite. Hence malaria occurs only in districts infested with certain mosquitoes. The fact that stagnant waters, which furnish the favourite breeding-places for mosquitoes, are present in such infected localities, has given the disease the additional name of marsh-fever.

Malaria usually manifests itself by attacks of fever which occur at certain intervals. These fevers are preceded by general symptoms, such as malaise, a sensation of leaden heaviness in the limbs, disinclination to bodily exertions, loss of appetite, nervous irritability, etc. In many cases, though not regularly, an attack begins with a violent chill, or at least with chilliness, which is followed by a sensation of heat. A more or less pronounced swelling of the spleen often develops at the same time. The duration of the attack varies. In mild cases it lasts about six hours ; in the severe ones, from thirty to thirty six hours. With the appearance of perspiration there is a more or less rapid drop in the temperature, accompanied in many instances with complete, or almost complete. recovery of health. This condition continues for a certain length of time, varying according to the form of the fever. Then an attack similar to the first one takes place. Unless suitable treatment is instituted. these attacks may continue to recur at longer or shorter intervals ; and in severe cases. particularly in persons who have been much weakened by fever, death may result from paralysis of the heart.

According to the periodicity of the fever, physicians distinguish between quotidian fever (recurring with one day's interval), tertian lever (two days' interval). quartan lever (three days' interval), etc. In individuals who live in malarial regions, and who are not treated more or less systematically for their attacks, a chronic malarial poisoning takes place which may be pro tracted for months or for years. In these cases the chief symptoms are swellings of the spleen and liver, dropsy, and inclination to hmmorrhages.

The specific remedy in most cases of malaria is quinine, which destroys the parasites. In order to attain this end, however, it is necessary that the proper quantity of the drug be given in each individual case, and that it be given in the right form and at the right time. The decision as to these points must be left to the attending physician. Persons who con template living in tropical regions in which malarial fever is prevalent, and in which medical aid can often be obtained only with difficulty, should never neglect to obtain thorough information regarding the nature of the disease and the proper administration of quinine in the same. The most important measure for the prevention of malaria is the extermination of mosquitoes by the destruction of their breeding-places, and the killing of their larvre. The best means for accomplishing this is through drainage of swamps, and the use of crude petroleum on stagnant pools. Protection against the bites of mosquitoes may be afforded by wearing proper garments, and by the use of mosquito-netting to prevent their invasion of dwellings. Quinine should be taken at judicious intervals.

MALE-FERN.—See ASPI DI UM.

seeds of the ordinary barley which have been germinated by moisture and heat and then dried. If this process has taken place at a moderate temperature, a starch-digesting ferment (diastase) is formed. This ferment is capable of converting about two thousand times its own weight of starch into dextrine and glucose. The various malt-extracts arc supposed to contain diastase, hut in many of them the ferment has been destroyed by heat. These preparations usually contain more or less alcohol and glucose, and are therefore of some nutrient value even though they fail in their object of aiding in the digestion of starches. Diastase is ultimately destroyed by the gastric-juice ; and in order to get the best results the malt should be taken immediately before meals.