ce is blue and cold, with severe headache, often
nausea and vomiting. Hot stage: this may last from one-half to five hours;
the temperature may increase somewhat, the face is flushed, the skin is
red and hot, great thirst, throbbing headache and full bounding pulse.
Sweating stage lasts two to four hours, and entire body may be covered;
fever and other symptoms abate and sleep usually follows. The patient
feels nearly well between attacks.

REMITTENT OR CONTINUOUS MALARIAL FEVER (Aestivo-Autumnal Fever).--This
form occurs in the temperate zone regions, especially in the summer and
autumn. The symptoms vary greatly. The fever may be irregularly
intermittent, but at longer intervals than the Tertian variety. The cold
stage is often absent, and in the hot the temperature falls gradually. The
appearance is often like typhoid for there may be then hardly any
remission of fever.

[INFECTIOUS DISEASES 229]

PERNICIOUS MALARIAL FEVER.--This is a very dangerous disease. The chief
forms are the comatose, algid and hemorrhagic.

(a) Comatose form is characterized by delirium or sudden coma (deep sleep)
with light temperature.

(b) The algid or asthenic form begins with vomiting and great prostration.
The temperature is normal or below normal. There may be diarrhea and
suppression of the urine.

(c) The hemorrhagic form includes malarial hemoglobinuria, hemoglobin in
the urine. Haemoglobin is the coloring matter of the red corpuscles.

Treatment. Prevention.--Destroy mosquitoes and protect from them by
screens. Small preventive doses of quinine for persons in malarious
regions, three grains three times a day. Five grains three times a day
will nearly always cure tertian and quartan cases, especially if the
patient is kept in bed until the time for one or two paroxysms has passed.
Attacks often stop spontaneously for a time when the patient is kept in
bed, even without the administration of quinine.

In Remittent Fever larger doses are necessary. For pernicious forms:
Hydrochlorate of quinine and urea ten to twenty grains, given
hypodermically, every three or four hours until improvement occurs, when
the sulphate of quinine by the mouth may be substituted.

AGUE. (See Malarial Fever.)--By ague is meant the cold chills and fever;
or dumb ague where there is little chill, mostly chilly and fever. These
attacks may come on every day, every other day, or every third day.

MOTHERS' REMEDIES. 1. Ague and Fever, Dogwood Good