The symptoms of this fever are so marked, that there is no difficulty in distinguishing it from all other forms. In remittent fever, the fever is never entirely absent during the remission, while in intermittent the paroxysm comes on, and in a few hours, passes entirely off, leaving the patient without any perceptible trace of the fever.

It prevails more extensively in marshy countries, particularly at the south and west, where the land is being drained, forests leveled, and the rich soil turned up by the plow. The air is poisoned with a miasm so subtile in its character as to defy detection, and yet so powerful as to prostrate the strongest man. It may also be developed after other diseases.

Diagnosis

The paroxysm is generally marked by three distinct stages, viz. 1st, cold; 2d, fever; and 3d, sweatig stage; although these stages sometimes seen commingled together. The symptoms in this disease are exceedingly variable. In some cases, the paroxysms appear every day, in others, every other day, and again, once in three or four days or even one or two weeks apart.

The cold stage is preceded by headache, languor, and a stretching sensation; blueness of the nails, and numbness of the toes and fingers. The coldness and shivering of the limbs and back gradually increase and pervade the whole body, the teeth chatter, the shivering is so violent as to shake the bed; the application of external warmth produces no immediate effect. There is oppression of the chest, pain in the head or stupor and delirium. The pulse is weak and oppressed.

This stage varies in violence and duration, lasting from half an hour to three hours, when it is followed by the hot stage.

This stage is characterized by violent fever, quick, wiry, and rapid pulse, great thirst, dry skin, flushed face, pain in the head, and sometimes delirium, hurried breathing, and oppression of the chest.

Lasts from three to twelve hours, when it terminates in the sweating stage, or, as is sometimes the case in warm climates, runs into remittent, or continued fever.

Sweating stage. The violence of the fever begins to abate and is succeeded by profuse perspiration: the pulse becomes less frequent, soft and full, and the aches and pains rapidly disappear, until all traces of the former violent paroxysm have entirely subsided.

Treatment

The remedies indicated are numerous, and should be selected with great care. No disease requires more care in the selection of remedies than this. A prominent remedy in distinctly marked intermittent, where all three of the stages are clearly and distinctly defined, is undoubtedly -

Quinine

Those of our Allopathic friends, who cure intermittent, without leaving after unpleasant consequences, would be somewhat surprised, if told the action of that drug is purely homoeopathic, and their patient is cured strictly on the homoeopathic principle.

Dose

Ten grains may be thoroughly triturated with twice the amount of white sugar, or sugar of milk, and made into ten powders, one of which can be taken every three hours, during the intermission of the paroxysm, or five grains may be dissolved in ten tablespoon-fuls of water, and a tablespoonful taken in the same way. During the paroxysm, the remedy must be discontinued. Even if it should not return, a powder should still be given every day for five or six days.

In addition to the above remedy, one or more of the following well selected, are frequently sufficient to produce a speedy cure. Acon., Ars., Ant.-crud., Ipecac, Nux-vom., Puls., Bry., Vcrat., Sab., Ig-natia, Cham., Lach., Rhus., Caps., Sulph., Op., Carbo-veg., Cocc., Bell.

Ipecac. is often highly beneficial in connection with Nux, particularly in the commencement of the disease.

Dose

A powder, or three globules, should be given every three hours between the paroxysms, and a powder or three globules of Nux, immediately after the attack. If the next attack should be equally violent, of course another remedy should be selected. If the tincture is given, one drop may be dissolved in a tumbler half full ol water, and a tablespoonful taken at a dose. The particular indications for Ipecac. are - much shivering with but little heat, or the contrary; shivering increased by external warmth; oppression of the precordial region: nausea, vomiting. It is also particularly indicated in that variety, where the third or sweating stage is scarcely perceptible.

Nux-Vom

This remedy as well as Verat., Bry., Bell., Coc, Puls, and Ipecac. will be found useful, where the bowels are constipated, and when errors-in diet give rise to bilious symptoms. It is more particularly indicated in those fevers, where the paroxysm comes on every day or every other day, generally in the afternoon, evening, or night, and where there is aching pain in the forehead, vertigo, nausea, and bitter taste; spasms of the stomach, and great weakness. We shall also find it useful, where there are, particularly at the commencement of the disease, paralytic weakness of the limbs, giddiness and prostration; difficult breathing, palpitation of the heart, shivering, followed by anxiety and warmth; violent headache, increased by walking and the open air; burning, itching, and sometimes delirium.

Dose

Same as Ipecac, with which it may be compared.

Belladonna

Violent headache with dizziness; shivering, with moderate heat, or the contrary. Heat with redness of the face and pulsation of the arteries.

Dose

Two drops or six globules, dissolved in a tumbler of water, a tablespoonful every two hours, during the paroxysm; where the fever has been of long-standing, every six hours during the intermission.

Arsenic - Is a prominent remedy in this disease, particularly where the stages are not distinctly marked, but are in a measure commingled; or where there is burning heat, with anguish, restlessness, and great thirst; great prostration of strength; nausea, retching and vomiting; severe pains in the stomach and throughout the body. Preceding the chilly stage, there is often stretching, yawning, headache, vertigo, with stupefaction; between the chilly and hot stage, debility and sleep, vertigo, thirst, nausea and vomiting.

Dose

Same as Ipecac, given during the intermission of the fever every three hours. (Compare Chin. Ipecac. and Verat.

Veratrum - Is indicated in those fevers which consist simply of external coldness, or internal heat, with dark urine, or when a warm sweat is present, soon becoming cold, accompanied with vertigo, nausea, and great pain in the back.

Dose

Same as Belladonna. Give every two hours during the continuation of the symptoms.

Pulsatilla

Will be found beneficial, where there is vomiting of mucus; moderate thirst, pain in the head, and oppression of the chest, during the cold stage, and shivering when uncovered, during the hot and sweating stage; aggravation in the afternoon or evening; gastric or bilious affections with their accompanying symptoms between the paroxysms.

Dose

Same as Belladonna. Give during the intermission of fever every two or three hours.

Ant

cr. - Has a close resemblance to Pulsatilla. The perspiration is simultaneous with the heat, and suddenly disappears leaving dry heat, thirst, want of appetite, nausea, vomiting, pressure in the stomach, and pain in the chest.

Dose

Same as Ipecac. Give same as Belladonna.

Bryonia

Where the paroxysms occur daily or every other day, particularly in the morning, preceded by vertigo, pain in the forehead; coldness and shivering more prominent than heat. During the chilly and hot stage, dry cough, stinging in the chest, asthma, nausea.

Dose

Same as Belladonna.

Opium

Particularly in young and old persons, where there is great drowsiness, snoring sleep, flushed face. Give a tablespoonful every two hours, during fever.

Dose

One drop or six globules in a tumbler of water.

Rhus

Is nearly related to Bryonia, with which it can often be given in alternation. The chilliness is sometimes attended with pain in the limbs, headache, vertigo, and nausea. There is generally great restlessness and thirst; gastric symptoms, nettle rash; convulsions and hardness of hearing.

Dose - Same as Belladonna.

Capsicum

Prevalence of the chilly stage, during which alone there is thirst, heat and sweat simultaneous; restlessness, headache or confusion of the head, sensitive to noise, vomiting of mucus, pain in the chest and back, tearing in the limbs, diarrhoea with slime and burning faeces. (Compare with Carb.-v.)

Dose

Three drops in a glass half full of water a tablespoonful during the paroxysm every hour.

Aconite

When the paroxysms of fever are violent, Aconite should be given, two drops in a tumbler of water, a tablespoonful every hour, in alternation if necessary with the Capsicum, Belladonna, or Opium.

For general directions as to the administration of remedies, see page 12.