Intermittent fever is one form of malarial fever. It has cold, hot and sweating stages, with a normal interval following. The patient may go through these stages every day, every other day, or every third day. This disease is caused by decaying vegetable matter. It prevails in new countries, river bottoms, districts which overflow, or in the neighborhood of canals or mill-ponds. It may prevail in houses with bad cellars, or where the sills and floors are in a state of decay. It does not make its appearance while the land is under water, but when the water recedes and exposes the half rotten vegetable matter to the sun. Some physicians suppose this disease to be caused by a microscopic vegetable germ which enters the system, contaminating the blood.

Intermittent fever is not self-protecting nor self-limiting. Some persons are never free from it while they reside in a malarial district. It runs an indefinite course if not checked by remedial agents. If not treated, the blood of the patient becomes impoverished, the lips pale, the skin sallow, the muscles weak and the body emaciated. The spleen becomes large, vulgarly called an ague cake. Some persons may become acclimated, improve, and finally get well without medicine, but the maHealth, Hygiene And Physiology. 403 jority would go from bad to worse and die, or become so weak as to have no physical endurance or resistance, and would finally succumb to some other disease which they, in the depraved state of the system, are not able to withstand. The system may become so surcharged with the poison as to cause death from the severity of the chill before reaction or the fever stage comes on. This is what is called a "congestive chill." Every chill is in reality a congestive chill - that is, during the chill some internal organ is congested, or contains an abnormal amount of blood; hence the variety of symptoms during this stage.

One may have difficulty of breathing because of congestion of the lungs; another may have pain in the head; another, in the stomach or heart.

Instead of the cold, hot and sweating stages, the patient may have severe periodical pains along the course of a nerve. This constitutes one form of neuralgia. At another time, or another patient, instead of suffering from either chills or neuralgia, may have a periodical diarrhoea, or there may be hemorrhage from some part of the mucous membrane.

Treatment

The night-air contains the malarial poison in greater abundance than that of the day, so that if persons must live in a malarial region, they can lessen the liability to contract disease by being in the house before sunset, and remaining there until after sunrise in the morning. An attack may be induced in some persons by eating anything which is difficult to digest. It becomes those who are susceptible to the influence of this virus to look well to their food.

Some preparation of Peruvian bark enters into almost every formula for the cure of intermittent fever. Sulphate of cinchona is the cheapest, but it is more likely to disturb the stomach. Cinchonidia is cheaper than quinine, and is like it in appearance. It is not as likely to disturb the stomach as the sulphate of cinchona, but more so than quinine. Quinine is more used because it is less irritating to the stomach, though it is of a higher price. Quinine is the king in this realm of remedies. If the interval between the paroxysms is short, we must give larger doses, and closer together. When the paroxysms are farther apart,. we can give smaller doses - three or four grains every two hours. We believe we shall have better effect from small doses close together than by giving doses of five or ten grains, four or five hours apart. We need, in ordinary cases, to administer from twenty to thirty grains between the paroxysms. The taste of quinine can be disguised by putting it in cold coffee or tea.

A few doses of bromo-hydric acid will prevent the disagreeable effects and the ringing in the ears produced by quinine.

Occasionally we meet with persons who cannot take quinine. We can use salicine in the same doses as quinine, or a little larger doses even.

Arsenic is used in chronic forms of the disease and may be used where quinine cannot be employed.

Nux vomica or strychnine may be used in combination with other remedies.