are not generally so profuse or colourless as the rice-water discharge which pours from the patient in true cholera; they retain a certain amount of biliary colouring, and may be mucoid or even bloody. As in cholera, the serous drain may lead to cramps in the limbs, loss of voice, pinched features, "washer-woman's fingers," almost complete suppression of urine, and, perhaps, to fatal collapse. Such attacks are very deceptive, and may be mistaken for true cholera. The high axillary temperature, if present; a history, maybe, of recent ague fits; the subsequent rapid disappearance of choleraic symptoms on the appearance of the hot and sweating stages; the colour of the stools, and other collateral circumstances, usually suffice for diagnosis, particularly if they are supplemented by a microscopical examination of the blood. Although not usual, recurrence of the choleraic symptoms may take place at the next fever period. A dangerous type of malarial fever prevalent in the Punjab is often ushered in by such symptoms; without the microscope its true nature may be hard to recognize.
Dysenteric and hæmorrhagic forms.—— Another form of pernicious attack is characterized by the sudden appearance of dysenteric symptoms; yet another by severe and recurring hæmatemesis, or by hæmorrhage from the bowel or elsewhere. The possibility of a suddenly developed dysentery being of malarial origin must therefore be kept in view; particularly if in what appears to be ordinary dysentery axillary temperature is found to be abnormally high. In every case of dysentery of this kind, or of hæmorrhage from stomach or bowel, in a patient who has recently been exposed to the chance of malarial infection, the possibility of the symptoms being an expression of malarial disease must never be overlooked; an examination of the blood must be made in all such cases before treatment is instituted.
Syncopal form.—— In the preceding types of algide pernicious malarial attack the dangerous symptoms mostly show themselves in the rigor stage of the fever. There is yet another form in which the danger
