Persons living in malarious countries often suffer from obscure difficulties, the cause of which may be usually mistaken for some other than the real one. In many cases it will be found that the real cause of a large number of peculiar affections, especially functional disturbances of the nervous system, is chronic malarial poisoning. One of the most frequent diseases produced by malaria is neuralgia, which most often affects the face. The intercostal and sciatic nerves are also frequently affected. Occasionally the heart is the seat of the neuralgic pain, in which case the patient suffers with very severe attacks of palpitation, difficulty in breathing, accompanied by a severe pain affecting the left side, and extending down the left arm.

In these attacks, the skin is generally cold and the patient may become unconscious. Paralysis of sensation, loss of hearing or speech, and other nervous disturbances may be produced by malaria. Sleeplessness at night and drowsiness during the day-time are other symptoms of chronic malarial poisoning. Jaundice, arising from an inactive condition of the liver produced by the poisonous influence of malaria, is very frequent.

Enlargement of the spleen, which almost always results from repeated attacks of malarial disease, sometimes gives rise to a peculiar coloration of all the internal organs. In a case of this kind, the condition of which we had the opportunity of examining, post-mortem, the brain was so deeply colored as to present a purplish appearance. When due to malaria, these affections are generally periodical in character. For example, malarial neuralgia will be likely to occur at a regular hour each day, as does the chill in ague.

The Treatment of Masked Intermittents

The only cure for this class of affections is elimination of the malarial poison from the system. Sometimes the patient is too weak to bear sufficiently vigorous treatment. In this case the employment of quinine is advisable. In some cases, the disease seems to resist all ordinary remedies, so long as the patient remains in a malarial locality, and it then becomes necessary to advise him to remove to a less malarious location. Fomentations, electricity, massage, and such other measures as are elsewhere recommended for the various conditions included under this head when produced from other causes, are equally applicable as means of palliation or of aiding in recovery.