216 
HISTORY OF MADAGASCAR. 
The symptoms of the fever, in its inflammatory state, are 
a severe head-ache, languor, pain in the eyes, especially on 
being turned upwards, dry and hot skin, vomitings, pain in 
the right side, great thirst, quick and hard pulse, a very 
foul furred tongue, aversion to food, flushing of the face, 
restlessness especially at night, loss of sleep, sometimes 
dread or fear, anxiety, hypochondriasis, delirium, an appa¬ 
rent improvement, and then death suddenly and unex¬ 
pectedly. 
In its most unfavourable appearance, the symptoms are 
cold and chills in the back, shoulders, and loins, stretching, 
lassitude, and a disposition to lie down, with great fatigue 
on the least exertion, a feeling of debility, anxiety, loss of 
appetite, thirst, uneasiness of mind, rigours, and sometimes 
stupor. This form is first remittent, and soon changes into 
an intermittent fever, which is divided into three stages of 
cold, hot, and sweating fits in a severe degree. The sensa¬ 
tion during the shivering fit is like being pierced with darts. 
This is followed, if it continues long, with hypochondriasis, 
dyspepsia, hepatitis, and dysentery; and unless the fever 
ceases with these symptoms, it speedily afterwards termi¬ 
nates in death. 
In regard to treatment, if the patient be robust, and has a 
hard quick pulse, Europeans have recourse to bleeding, and 
other means of reducing the system. When there is much 
thirst and a hot dry skin, an anodyne antimonial draught is 
sometimes found useful. If after this no change for the 
better be observed, mercury is administered, so as to 
produce ptyalism as speedily as possible, which in general 
diminishes or removes every unfavourable symptom. 
Tonics, such as cinchona bark or the sulphat of quinine, are 
afterwards administered, and the patient recommended to 
drink plentifully of rice-water, or some acidulated beverage. 
