An intermittent fever is not of itself a dangerous disease, but it may become so by concomitant symptoms; a long duration of the fever may occasion a peculiar cachectic state, dropsy, nervous affections, etc.

Exciting causes are: low marshy regions, stagnant waters; atmospheric miasmata occasioning, epidemic intermittent fevers; colds and wet skin, lying upon a cold soil or floor; excessive use of cold water, heavy dishes of flour, acid fruit containing a good deal of water, fish.

§ 88. It is important to give the remedy immediately after the paroxysm. If the apyrexia should be very short or some of the symptoms of the paroxysm should remain during the apyrexia, the medicine should be administered when the sweat commences to abate or the symptoms which usually appear in the wake of a paroxysm begin to disappear. It is likewise expedient to repeat the homoeopathic specific a few hours before the next paroxysm.

The treatment of intermittent fevers is not as easy as it would seem at first sight; every case of intermittent fever has to be examined independently of any other case, for this reason, that almost every case differs from the other, even in an epidemic intermittent. In every case of intermittent fever the character of the chills, heat and thirst (not so much the sweat) has to be minutely inquired into; next to that the concomitant symptoms and the symptoms of the apyrexia, especially those which remain from the paroxysm. The type scarcely ever determines the selection of the homoeopathic agent, since any type can be controlled by it, provided it is otherwise homoeopathic to the symptoms. Puls., Ipec, Nux, etc. are most suitable to quotidian, and Arsenic to quartan intermittent fevers; still they will remove fevers with any other type, provided the symptoms correspond.

A writer in the Archiv advises in some fevers to give four doses of Ipec. at equal intervals, and a dose of Nux in the next apyrexia.

The endemic intermittent fevers of marshy regions are most speedily removed by a few doses of China, higher potencies. If this kind of fever should not yield to China in persons who have sufficient exercise and otherwise live carefully, the cause is to be found in the psora having become roused from its latent state; all such cases require an antipsoric treatment.

Some very experienced homoeopathic physicians administer a few doses of Aconite, higher potencies, a few hours previous to the paroxysm if it be violent. This proceeding is not irrational, as every paroxysm partakes more or less of the character of a synochal or erethic fever and is most readily controlled by Aconite.

The principal remedies against intermittent fever are: China, Quinine, Ars., Verat., Arnica, Ant. cr., Nux, Bell., Cocc, Caps., Carbo veg. and anim., Can-thar., Ignat., Lach., Puls., Sabad., Sepia, Dig., Bryo., Dros., Dulc, Natr. mur., Lye, Staphys., Sulph., etc.

China corresponds more or less to the following symptoms; no thirst during the chilly stage, thirst between the chilly and hot stage; China is not suitable when thirst is present in the hot stage; if thirst be present during the hot stage of a China-intermittent, the heat ought simply to be a burning or dryness of the lips which require moistening, but no real thirst is experienced by the patient. If the thirst set in after the heat, or during the sweaty stage, China is the remedy. China corresponds, if the fever should commence with a secondary symptom, such as: palpitation of the heart, anxiety, frequent sneezing, nausea, great thirst, canine hunger, oppressive pain in the abdomen or head; or if the veins should become distended when the head feels hot, or when the temperature of the body is slightly raised, or when the patient merely feels hot to himself and not to others, or when the skin feels hot to others. China is moreover indicated by congestion of blood to the head, redness and heat of the face, generally accompanied with chilliness and coldness to the touch of the extremities, or by heat of the face which is perceptible only to the patient, the face feeling cold to the hand, with cold sweat on the forehead.

Nux, together with Verat., Bryo., Bellad., Coc, Puls., deserves consideration when the bowels are confined, or when gastric or bilious symptoms make their appearance in consequence of gross errors in diet; or when nervous symptoms set in in consequence of the spinal marrow being more or less irritated. Nux has so far proved most useful in quotidian and tertian fevers, which make their appearance in the afternoon, evening or night, consisting of alternate chilliness and heat, with great desire for beer; aching pain in the forehead, vertigo, nausea, bitter taste and eructations, spasms of the stomach, great weakness, all these symptoms setting in even at the commencement of the paroxysm. In intermittent fevers, accompanied with bilious and gastric symptoms, Cham., Ant. cr., and Puls, are on a par with Nux, (see the chapter on bilious and gastric fevers). Nux is highly important in some kinds of the so-called apoplectic intermittent fevers, with vertigo, anguish, feverish shiverings, a peculiar kind of delirium, consisting of vivid and sometimes frightful visions, and occasioning a tightness in the region of the stomach, typhoid and febrile symptoms being intermingled. Nux will prove serviceable in fevers where the following symptoms set in in the very commencement of the attack: paralytic weakness of the limbs, debility in the knees and feet, excessive weariness, tremor, sudden failing of strength, swoons, vertigo, with vanishing of the senses, giddiness and weight of the head as in a state of intoxication, desire to lie down; troublesome, anxious breathing, palpitation of the heart, fear of death, qualmishness, shiverings, followed by anxiety and warmth; warm cheeks, with internal shiverings; the face feels hot, with shiverings over the rest of the body; heat in the head, with coldness of the body; burning in the eyes, without any inflammation being present; tearing, beating, stinging headache, increased by walking, and by the open air; loss of appetite, aversion to bread; bitter and sour eructations; fancies in the night in a state of half sleeping or waking; furious delirium; burning, itching rash, and a burning itching of the whole body. The exhibition of Belladonna depends, like that of Nux, more upon the concomitant symptoms than upon the character of the paroxysm itself. Belladonna being a great remedy for diseases which return periodically, it must be of great use in curing the regularly recurring painful paroxysms of fever and ague, where the chilliness is but slight, the heat is sometimes accompanied with chills, sweat and thirst are moderate, and the patient drinks merely for the purpose of relieving the dryness of his mouth and fauces. Belladonna is sometimes suitable in a quotidian intermittent, when the paroxysms are accompanied with the following symptoms: violent headache, with vertigo; hallucinations, redness of the eyes, nausea, vomiting, constipation, chills, or simple chilly creeping over the skin, with thirst without any considerable heat afterwards, moderate increase of the temperature of the skin, sweat. Bellad. deserves consideration in fevers of long standing, or in those which had been suppressed by Quinine and have returned afterwards, with swelling of the liver and spleen, incipient dropsy, derangement of the digestive powers, and violent headache during the paroxysm.