CHAPTER XVIII. 



MALARIA. 



MALARIA, or paludism, has been known since the days of 

 ancient medicine, and has always been regarded as the 

 typical miasmatic disease. Its name, mala aria, means 

 " bad air," and is Italian derived from the Latin, mains and 

 aer, coming from the Greek dyp, air, from dew, to blow. 

 The other name, paludism, from the Latin pains, a " marsh," 

 refers the disease to the bad air coming from marshes. 



It is a disease of extremely wide geographic distribution, 

 and since the supposed requirement, marshy ground, is 

 found in nearly all countries, and the disease is particularly 

 prevalent in the marshy districts of those countries in which 

 it occurs, the connection between the marshes and the disease 

 seemed clear. Indeed, the two are intimately connected, 

 but not in the original sense, as will be shown below. 



Both hemispheres, all of the continents, and most of the 

 islands of the sea suffer more or less from malaria, and in 

 many places, especially in the tropics, it is so pestilential as 

 to make the country uninhabitable. Probably no better 

 idea of the wide distribution and severity of the disease can 

 be obtained than by reference to Davidson's " Geographical 

 Pathology." * 



The disease assumes the form of a fever of intermittent or 

 remittent type, characterized by certain peculiar paroxysms. 

 When typical, as in well-marked intermittent fever, these are 

 ushered in by depression, headache, and chilly sensations, 

 which are soon followed by pronounced rigors in which the 

 patient shivers violently, his teeth chattering. The tem- 

 perature soon begins to rise and attains a height of 102, 104, 

 or even 106 F., according to the severity of the case. As 

 the temperature rises the sense of chilliness disappears and 

 gives place to burning sensations. The skin is flushed, hot, 

 and dry. After a period varying in length the skin begins 

 to break out into perspiration, which is soon profuse, the 



* D. Appleton & Co., New York, 1892. 

 524 



