388 REPORT OX THE DISEASES AMONG THE 



REMITTING FEVER. 



This fever varies so much in its appearance, from climate, 

 situation, and the revolution of seasons, that a stranger in the 

 West Indies would be at a loss how to class it. Sometimes 

 it is mild in its appearance, and regular in its form ; at other 

 times it is more violent, and of an unfavourable aspect. 

 There scarcely exists a boundary betwixt a remittent and 

 an intermittent fever ; the double tertian seems to be one 

 and the same thing, differing only, perhaps, from circum- 

 stances. 



Symptoms. — At first the patient has uneasiness, with lan- 

 guor, and, as he expresses it, is neither sick nor well. He 

 has, afterwards, alternate heats and rigors, the heats especial- 

 ly in the extremities. 



Headach and prostration of strength, nausea and frequent 

 vomiting supervene, first of the contents of the stomach, af- 

 terwards of bile, of a yellow or green colour. The pulse at 

 first is small and quick, afterwards full, but seldom hard. 

 For the most part, there are pains in the back and loins, 

 pains in the limbs, particularly the calves of the legs, and 

 fore-arms. Frequently the patient complains of an acute 

 pain at the top of the shoulder; others have universal pains 

 over the whole body ; and most of the sick have anxiety, 

 great restlessness, and frequent sighing. As the heat in, 

 creases, the face is flushed, and all the symptoms become 

 worse. The headach is greater, and the patient is drowsy, 

 or comatose : a sweat at last succeeds, which procures a par- 

 tial abatement of the disorder. The tongue at first is white 

 and slimy ; but, in ardent cases, both the tongue and fauces 

 become dry, brown, and chopt. 



In most cases, at the beginning, there is little or no thirst; 

 but in the advanced stage it is verv great. 



