RELAPSING FEVER 



startling feature of relapsing fever. Within a few hours 

 the temperature in the axilla reaches 103 F. or beyond. 

 While usually showing a diurnal variation of about 2 F., 

 being lowest in the morning, the temperature remains at 

 a high level throughout the initial attack, with an upward 

 tendency as the crisis is approached. At the acme of the 

 fever a temperature of 105 F., 106 F., or even higher, is 

 not uncommon, but as it is not long maintained is of less 

 serious import in this than in most other acute fevers. 

 The crisis, while usually occurring on the seventh day of 

 the primary attack, may often be accelerated or delayed 



FIG, 53. Relapsing Fever. Indian. 



a day. Rarely the crisis occurs on the ninth day, or 

 still more rarely on the fourth. Whenever it occurs the 

 critical fall of temperature is usually very sudden, reach- 

 ing the normal point or, more commonly, a degree or 

 two below it within twelve hours. 



The temperature remains subnormal for tw r o or three 

 days, then rises to the normal point, where it remains 

 until a relapse occurs. The course of the fever in relapses 

 is similar to that of the initial attack, tending, however, 

 to be less abrupt in its onset, to show greater daily 

 oscillations and to be of shorter duration. In fact, all 

 the symptoms of a relapse are less typical than those 

 of the initial attack. The interval between each suc- 

 cessive relapse also tends to be longer. Thus, while the 

 ordinary duration of the initial attack is seven days, and 



