90 DISEASES DUE TO PROTOZOA 



Fever rapidly declines. The urine is as in the hot stage. 



Distressing symptoms abate, relief comes, patient sleeps readily. 



Temperature may fall to normal or sub-normal. 



Apart from weakness the patient feels well. 



The whole attack lasts from six to ten hours, but may vary much. 



A similar attack takes place one, two or three days later, unless 

 quinine is given in the interval. 



The spleen enlarges temporarily, but remains slightly larger after 

 each attack. In frequent attacks the spleen may be enlarged enor- 

 mously, permanently and accompanied by a cachectic state. 



The most pernicious fevers, so common in Africa, are most 

 atypical ; the patient may reach a serious condition before a doctor is 

 consulted. 



The rise of temperature is caused by the discharge of malarial toxin, 

 when the red cells rupture, and not because of the parasites being 

 liberated in the serum. Between attacks the young parasites are grow- 

 ing to maturity in fresh red cells to cause another rise of temperature, 

 when the latter are ruptured. 



There are continued and remittent types of malarial fevers, when 

 parasites of all stages may be met with in the red cells. 



CLASSIFICATION. 



Acute Malaria. 



13 . ^ , j Simple, Triple, 



^ ■^ I Double, Mixed, 



D . T, ,. ( Simple. Double, 



Benign leniaii. ... \ ^ ^ . , ,. 



** ] Irregular subcontmuous, 



Malignant or Simplf^, 

 Siihtertian. Double, 



(Crescents.) Irregular, 



-to" 



Do not 

 form crescents. 



Remittent, 



typhoid. 



adynamic. 



bilious. 



Pernicious with general symptoms, e.g., 



Algide, Diaphoretic, 



Hemorrhagic, Scarlatiniform. 



Pernicious with local symptoms, e.g.. 



Cardiac, 

 Pulmonary. 



Pulmonic, 



Pleuritic. 

 Gastrointestinal, 



Choleraic, 



Dysenteric, 



Haemorrhagic pancreatitis, 



Peritonitic. 



