fevers are usually distinct intermittents. Fresh infections occurring in these places and seasons, so far as the subject has been studied, are found to be produced by the tertian and quartan parasites, and are, therefore, of little danger. Relapses, however, of malignant infections, originally contracted during the hot weather, may occur during the cold season in fact, are far from uncommon then.
First attacks, though produced by one of the benign parasites, may assume the characters of a remittent; generally, in temperate latitudes, they are frank intermittents. First attacks of malignant malaria, although they may in a few instances be intermittent, are in the majority of cases remittent in type. So are the attacks resulting from extensive reinforcement by fresh parasites (through fresh infection) of the old stock which a fever subject may carry about him in a latent condition. The first attack experienced by a newcomer to a highly malarious district with a hot climate is, therefore, generally remittent and severe.
It is neither necessary nor desirable to attempt to describe in detail the infinite variety malarial attacks exhibit. It would be impossible in a limited space to do so; and, if done, the result would amount only to an uninteresting and unprofitable ringing of the changes on rigor, pyrexia, diaphoresis, bilious vomiting, bilious diarrhrea, constipation, catarrhal gastritis, headache, bone-ache, prostration, and so forth. The picture would be further confused by the fact that the natural procession of events is generally, nowadays, disturbed by the action of quinine, the use of which is almost universal with Europeans in the tropics; so that it is difficult to say how any given malarial fever would develop, or how it would terminate, if untreated. Sometimes in the case of natives of tropical countries, who may not always command a few grains of quinine, such fevers pass into a typhoid state, with dry brown tongue, sordes in the mouth, and muttering delirium, and may end in collapse and death. In others, untreated remittents and intermittents gradually subside spontaneously in the course of a week or fortnight; or
