Page:Malarial fever; its cause, prevention and treatment; containing full details for the use of travellers, sportsmen, soldiers, and residents in malarious places (IA malarialfeverits00rossuoft).pdf/20

4 lasting from a few hours to a day or two, and separated from the next attack by fever-free intervals. This kind of fever is called intermittent fever, and the intervals are called intermissions.

It often happens that the attacks of intermittent fever succeed each other with great regularity. When they come on every day, we have a quotidian fever; when they come on every other day, we have a tertian fever; and where they occur every third day, a quartan fever.

It was shown by Torti some centuries ago that a remittent fever is really nothing but an intermittent fever in which the successive attacks are so frequent or prolonged that, so to speak, they run together and pro- duce a continuous fever. Most patients suffer at first from the remittent type of fever, which, after a week or more, tends to break up into the intermittent type.

We should here be careful to note that the symptoms may be much modified if the patient has been taking quinine. Large doses of this drug will generally cut short the succession of attacks; while moderate doses will shorten them and prolong the inter- missions. Thus a patient who has been taking quinine as a precautionary measure may have only a few slight attacks of fever, in place of the severe illness described above.

If the patient cannot or does not take sufficient quinine, the progress of the case is often as follows:-- After some weeks (if the patient lives) the fever goes away of itself, leaving the sufferer very weak and anaemic. It may be absent for weeks or months, during which he often flatters himself that he is cured; but suddenly it comes on again as violently as before. This is called a relapse; and it is followed by another period of improve- ment called a rally. These rallies and relapses may follow