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or Intermittent Fever Malaria

grains, quinine, dose, day, sulphate and grain

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MALARIA, or INTERMITTENT FEVER, is a febrile affection characterised by intermitting attacks of fever, chills, muscular pains, and perspiration. The disease is caused by micro-organisms belonging to the lowest animal group. These organisms enter the red blood-cells and destroy them. Mosqui toes of certain species transmit the affection from one person to another, so that it occurs only in certain districts.

Treatment.—The specific remedy for the affection is quinine, which should be taken at judicious intervals. Adults may take it in capsules or as Warburg's tincture or Warburg's pill.

In ordinary intermittent fever 15 to zo grains of quinine sulphate would constitute a daily dose ; this should be so arranged that the last dose is taken about three hours before the expected chill, and should be divided into five doses of 3 or 4 grains each in a capsule. In the morning a light purgative, such as dessertspoonful of syrup of rhubarb, should be taken. This treatinent must be continued until the chills disappear, when the remedy i, gradually withdrawn by reducing it by one dose everv other day. If quinine in this form does not agree with the patient, Warburg's tinctuie may he substituted, teaspoonful to tablespoonful every three hours, altei the bowels have been thoroughly evacuated.

Dr. Warburg's quinine pill consists of grain of extract of aloes, A grain of rhubarb, A grain of angelica-seed, .1 grain each ol elecampane, saffron, fennel, zedoary root, cubebs, myrrh, white agaric, camphor, and IA. grains of quinine sulphate, with a sufficient quantity of gentian to form a mass. The dose should be to 3 pills once to three times a day.

A quinine tablet used officially in the United States army, which has given excellent results in Cuba, consists of : Aqueous extract of al( es, 26 grains ; rhubarb, 56 grains ; angelica-seed, 56 grains ; elecampane 26 grains ; Spanish saffron, 2S grains ; fennel, 2S grains ; gentian, 14 giains ; zedoary root, 14 grains ; cubebs, 14 grains ; myrrh, 14 grains ; white agaric, .14 grains ; camphor, 14 grains ; quinine sulphate, 16 grains. This would

make 155 tablets, and the dose is 2 tablets every three hours.

Dissolve in 2 quarts of water too grains of quinine sulphate, bo drops of sulphuric acid, S ounces of Epsom salt, S ounces of lump sugar, and add A quart of brandy. Shake well before taking; the dose should be a wineglassful three times a day.

For children the dose of quinine sulphate should he grain five times a day, the last dose three hours before the expected chill, to be given in syrup of chocolate or elixir of liquorice. The best way to administer quinine sulphate to children is in \Varburg's tincture or pill, A teaspoonful to r teaspoonful or pill three times a day. Of the United States army prescription give A to tablet every day.

In severe attacks, such as the estivo-autumnal fever, larger doses of quinine sulphate should be given, 3o to 4o grains a day, for aduits, divided into 5 doses.

acute, eruptive, infectious disease of which one attack usually renders the subject immune to the disease. For this leason adults are seldom affected, as generally they have had measles in childhood The period of incubation—that is, the time that elapses between the infection with the virus of measles and the appearance of the eruption of the skin— is from ten to fourteen days.

The disease begins abruptly with alternate chills and flushes of fever, the head aches, the tongue is furred and white, the eyelids are swollen, the eyes are bloodshot, heavy, and watery ; coughing and sneezing follow, and the catarrhal symptoms, particularly the cough, are usually aggravated on the appearance of the eruption. This begins on the face, and usually spreads over the entire body within twenty-four hours. The spots are either light or dark red, are raised slightly above the skin, and vary in size from a pin-head to that of a pea. They either appear in isolated spots, or merge into patches that cover large areas of the skin. Three or four days after its onset the eruption begins to fade.

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