ong children of the wealthier
classes. I believe it is everywhere rarer among children than among
grown persons, probably because they are as a rule less exposed to those
malarious influences which produce it. In the child it generally takes
the form of tertian ague, that is to say the attack recurs every second
day; one day of freedom intervening between two attacks.

The three stages of shivering, heat, and sweating are less marked in the
child than in the grown person, and this indistinctness of its symptoms
is greater in proportion to the tenderer age of the child. Shivering is
scarcely ever well-marked, a condition of unaccountable depression
usually taking its place, while once or twice I have known convulsions
occur which gave rise to the apprehension that disease of the brain
existed. The hot stage is long, and passes off gradually without the
profuse perspiration that occurs in the grown person, and the child even
between the attacks is almost always more or less ailing.

A first and even a second attack may puzzle not the parents only, but
also the doctor; but after the symptoms have returned a few times, the
child being neither better nor worse in the intervals, it becomes
evident that no serious disease is impending. The risk of an overhasty
conclusion is that the depression and disturbance of the nervous system
may be supposed to imply the existence of brain disease; and lead to
unsuitable treatment, instead of the administration of quinine, which
nine times out of ten proves a specific for ague. The rapid increase of
temperature in the attack, and its equally rapid subsidence afterwards,
will, if carefully noted, preserve from error.

There is much that is obscure with reference to the nature both of
rheumatic and intermittent fever. They differ from other fevers not only
by being neither contagious nor infectious but also by their readiness
to return, while a single attack of any of the others furnishes a
guarantee, and often a complete guarantee, against its recurrence. In
addition to these peculiarities, the fevers of which I have now to speak
are characterised by running a certain definite course, being
accompanied by certain peculiar appearances on the surface (generally
rashes on the skin, whence their name of eruptive fevers); being
attended each with its own peculiar dangers, and all having a tendency
to what is termed epidemic prevalence; that is to say to occur one year,
and without obvious cau