REMITTENT FEVER. 117

CHAP. XV.

REMITTENT FEVER.

This fever takes its name from a remission of the symptoms,which happens sometimes sooner and sometimes later, but gener-ally before the eighth day. The remission is commonly precededby a gentle sweat, after which {he patient seems greatly relieved,but in a few hours the fever returns. These remissions return atvery irregular periods, and are sometimes of longer, sometimesof shorter duration : the nearer, however, that the fever approach-es to a regular intermittent, the danger is the less.

Causes. — Remittent fevers prevail in low marshy countriesabounding with wood and stagnating water ;* but they prove mostfatal in places where great heat and moisture are combined, as insome parts of Africa, Bengal, in the East Indies, &c. where re-mitting fevers are generally of a putrid kind, and prove very fatal.They are most frequent in close calm weather, especially afterrainy seasons, great inundations, or the like. No age, sex, or con-stitution is exempted from the attack of this fever ; but it chieflyseizes persons of a lax habit, who Jive in low dirty habitations,breathe an impure stagnating air, take little exercise, and use un-wholesome diet.

Symptoms. — The first symptoms of this fever are generally yawn-ing, stretching, pain, languor, and giddiness in the head, with al-ternate fits of heat and cold. Sometimes the patient is affectedwith a delirium at the very first attack. There is a pain and some-times a swelling, about the region of the stomach, the tongue iswhite, the eyes and skin frequently appear yellow, and the patientis often afflicted with bilious vomitings. The pulse is sometimesa little hard, but seldom full ; and the blood, when let, rarelyshows any signs of inflammation. Some patients are exceedinglycostive, and others are afflicted with a very troublesome looseness.

It is impossible to describe all the symptoms of this disease, asthey vary according to the situation, the season of the year, andthe constitution of the patient. They may likewise be greatlychanged by the method of treatment, and by many other circum-stances too tedious to mention. Sometimes the bilious symptoms

* Although originally produced by marsh miasma, and in its simple state not of aninfectious nature, this fever under bad management, such as crowding too many sicktogether, neglecting proper cleanliness and a free ventilation, there cannot be a doubtthat it may in its course engender a matter capable of occasioning a fever of a highlycontagious nature j and although remittent fever cannot be communicated at any gr«atdistance from the source of its exciting cause, however severely and epidemically itmay prevail in certain situations and district« ; and although the matter producing itbe essentially the same, still we may conclude, " I think," says Dr. Thomas ; {a) u thata more aggravated form of the disease is occasioned by a more concentrated state ofthe person : hence the different deg-ees of severity of remittent fever at different periods of the year, and in different climates." Ed.

(a) Modern Practice of Physic.

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