SUBTERTIAN MALARIAL FEVER 



43 



associated with jaundice, it is often popularly called 

 bilious remittent fever. Constipation is the rule, but there 

 are exceptions. In many of the cases of this form of 

 malaria, when the parasites, though not very numerous, 

 are not difficult to find, the temperature is not high, 

 sometimes not exceeding 100 or 101 F. (fig. 17). 



Hyperpyrexia has been frequently described, and there 

 can be no doubt that, as in other toxic diseases, it must 

 occur. In most of the recorded cases there has been no 

 blood examination and no post-mortem examination, so 



FIG. 19. Hyperpyrexia in Malaria. 



that the malarial nature is not proved. Fig. 19 is of a 

 case in which the temperature was at one time over 

 108 F., and the recovery under quinine is a proof that it 

 was malaria. 



In benign tertian, in spite of the severe attacks of fever, 

 the patient may be in good health during the intervals. 

 In subtertian this is exceptional. The patient may be 

 able to be up and force himself to attend to business or 

 pleasure, but these attempts at " fighting the fever " are 

 responsible for many serious errors of judgment, as well 

 as causing serious risk to the patient. 



