INTERMITTENT FEVER. (581 



to cut short the entire disease ; but, for the most important and dan- 

 gerous symptom, the fever, quinine is almost infallible. After giving 

 proper doses of quinine, the patient almost always escapes a series of 

 paroxysms ; and, as the cachexia and impoverishment of the blood, 

 and, to some extent, the spleen-affection also, probably depend on the 

 fever, the patients not only do not grow worse during the administra- 

 tion of the quinine, but they improve and pick up even if the disease 

 be not entirely extinct. Although, for the sake of brevity, we may 

 designate as relapses the many cases where paroxysms recur shortly 

 after stopping the quinine, strictly speaking, it is incorrect ; for the 

 cases where these so-called relapses occur, even after moving into a 

 region free of malaria, prove that the disease was not cured, but only 

 one of its symptoms removed. The homoeopaths assert that under 

 their treatment there are no relapses : there is some truth in this as- 

 sertion ; for, when the paroxysms have ceased under homoeopathic 

 treatment, the disease is certainly all gone. The fact, that, after the 

 administration of quinine in sufficient doses, relapse does not occur in 

 jiany cases, rather favors the view that, besides its palliative action 

 on the paroxysms, this medicine has also a favorable influence on the 

 entire disease caused by the malarial infection ; but it is also possible 

 that in such cases the palliative action continues till the disease passes 

 off spontaneously. When the action of quinine is only palliative (as 

 it is in the majority of cases), usually about seven, fourteen, or twenty - 

 one paroxysms are missed, and the next one occurs in about two, three, 

 or four weeks, rarely sooner. According to my own observation, the 

 assertion, that the relapses almost regularly take place the fourteenth, 

 twenty-first, or twenty-eighth day, is exaggerated ; I have far more 

 frequently seen relapses a few days before or after these dates. It is 

 not at all rare for relapses to occur three or four times, or oftener, and 

 for the disease to run on interruptedly for months, before actually 

 ceasing. I deem it proper to speak of the modification of the course 

 of intermittent fever by quinine under symptomatology, because, ae 

 we have already said, most physicians have no opportunity of ob- 

 serving intermittent fever without this modification of its course. 

 Much that is said in the text-books on medicine, about the course of 

 intermittent fever, certainly does not refer to the disease when left to 

 itsel 



1L Pernicious Intermittent Fever. Intermittent fever may prove 

 dangerous to children, to the aged, and to very debilitated or sickly 

 persons, without being of unusual intensity or duration, or having any 

 complications. Children inclined to convulsions not unfrequently have 

 an epileptiform attack during the cold stage, as they also have in the 

 initiative chill of inflammatory diseases. This is not usually danger- 



