- Another form of malarious fever is the congestive. It may be either remittent - that is, abating considerably; or intermittent - that is, having intervals of entire freedom from fever. It may have intervals of twenty-four or of forty-eight hours. The first attack does not differ from that of a simple intermittent, and may excite but little attention; but the second is always severe, producing great coldness, and a death-like hue of the face and extremities. The advancement of the disease brings dry, husky, parched, and pungently hot skin, followed after a time by a cold, clammy sensation. The eyes are dull, watery, and sometimes glassy; the countenance dull, sleepy, distressed; the tongue, at first white, changes to brown or black, and is usually tremulous; the breathing is hurried and difficult. Pressure over the liver, stomach or bowels, produces pain. The mind is often disturbed, and falls into lethargy and stupor, or is delirious. The treatment should be nearly the same as in bilious remittent. While convalescing, the diet must be light and nutritious at first, increasing in quantity as the strength returns. Use a mild tonic if the patient is weak. Exercise out of doors must not be neglected.