NURSING IN MALARIAL FEVER 59 



severe cases on account of the risk of cardiac failure. In 

 mild cases, if the headache be severe, they give relief and 

 are harmless. 



Management. One of the points that is constantly 

 arising in connection with malaria is the advisability of 

 allowing the patient to work during the intervals of an 

 attack or, in the case of subtertian, when the patient is 

 still suffering from a low type of fever. In both cases 

 recovery is delayed by any attempt at getting up, exposure 

 of any kind, or work, whether physical or mental. 



In benign tertian and quartan fever it may be permis- 

 sible for urgent work to be done during the apyrexial 

 interval. This should be restricted as far as possible to 

 routine work. It must always be remembered that work 

 done under these conditions is inferior. With the 

 subtertian fever, even though the temperature be normal 

 or nearly so, no responsible work should be undertaken 

 as the patient is incapable of acting with judgment. 

 Instances of grave errors resulting in serious calamities 

 are common. A very decided stand has, therefore, to be 

 taken in these cases, as one of the prominent symptoms 

 is an obstinacy which leads the patient to insist on doing 

 work when he is mentally incapable of dealing with it 

 satisfactorily. 



As regards residence in a malarial country of a person 

 who has suffered severely, the general condition has to 

 be considered, as well as the completeness of the recovery. 

 There is no reason why return should not be allowed if 

 these points are satisfactory, as there is no increased 

 liability to reinfection. On the contrary, there is a 

 variable amount of partial immunity. 



Nursing. In an ordinary attack of malaria skilled 

 nursing is hardly required except for comfort. The 

 patient, moreover, is often irritable, or may be slightly 

 delirious, and no unwelcome attentions should be per- 

 sisted in except such as may be absolutely necessary. 

 He should be protected from noise, bright light, and 

 above all from draughts. 



