What is known as ague cake, consists of an enlargement of the spleen, which is one of the results of chronic malarial poisoning. The spleen is also enlarged in typhoid fever, typhus fever, and various other febrile affections. When a person has been long exposed to the influence of malaria, the spleen frequently becomes so greatly enlarged that it can be felt beneath the lower ribs on the left side. In some cases, enormous enlargement occurs, the organ becoming fifteen of twenty times its natural size. The result of enlargement of the spleen is, in some cases, a condition which has been previously described as lukaemia, a condition in which there is a very great increase in the number of white blood corpuscles, more or less pain and tenderness which is increased on taking a deep breath, on coughing, sneezing, or producing pressure over the organ, and an unpleasant feeling of weight in the left side in consequence of the enlargement of the spleen.

Enlargement or congestion of the liver also generally exists in these cases, as indicated by symptoms on the right side similar to those already described.

The Treatment of Ague Cake

Mosler, Hartz, and other eminent European physicians recommend very highly the use of the cold douche over the region of the spleen, applied from one to three minutes daily. Dry packs are also a favorite and a very successful remedy in Germany. In India, the disease frequently treated by means of puncturing with long needles. The treatment is said to be successful. Our plan of treatment is the alternate hot and cold spray or douche, applied over the spleen, general derivative baths, as packs and hot-water baths employed two or three times a week, and the local use of electricity. When electricity is used, the two poles should be applied over the spleen in such a way as to pass the current through it. Enlargement of the spleen is said to be curable by the use of the various preparations of Peruvian bark. A remedy to which attention has been more recently called, is the use of the milky juice of the unripe fruit of the pawpaw tree. A teaspoonful of the juice is mixed with sugar and divided into three parts, which are taken at equal intervals during the day. Electricity used in the manner described is very highly recommended by eminent Austrian physicians, and we consider it of great value.