Remittent Fever is one of the varieties of fever arising from malaria or marsh-poison—one being Intermittent Fever, or Ague (q.v.). In its milder forms it scarcely differs from severe intermittent fever; while in its more serious form it may approximate closely to yellow fever. As the nature of the poison on which it depends is sufficiently noticed in the article MALARIA, we shall at once proceed to describe the most characteristic symptoms. The attack may be either sudden or preceded by languor, chilliness, and a general feeling of malaise. Then comes a cold stage, usually of short duration. This is followed by a hot stage, in which the symptoms are commonly far more intense than those exhibited in the worst forms of ague. Giddiness proceeding to delirium is not uncommon, and is a bad symptom; while in other cases drowsiness or lethargy is one of the most marked symptoms. There is often great tenderness or pain in the region of the stomach, and vomiting—the vomited matter frequently containing bile or blood. A remission of these symptoms occurs, in mild cases, in six or seven hours; but in severe cases the paroxysm may continue for twenty-four hours or longer. The remission is sometimes, but not always, accompanied with sweating. The duration of the remission is as varied as that of the paroxysm, varying from two or three to thirty hours, or even longer. The fever then returns with increased severity, and without any cold stage; and then the paroxysms and remissions proceed, most commonly according to no recognisable law, till the case terminates either fatally or in convalescence. In favourable cases convalescence is usually established in about a week. The severer forms of this fever are often accompanied with more or less jaundice, and hence the disease has received the name of bilious remittent fever. It is also known as jungle-fever, lake-fever (from its prevalence on the border of the great American lakes); and the African, Bengal, Levant, Walcheren, and other similar local fevers are merely synonyms of this disease. In England the disease is very rare; and when it occurs it is usually mild. The disease is most severe in southern Asia, western Africa, Central America, and the West India Islands.
The first object of treatment is to reduce the circulation during the hot stage. This is done by a dose of five grains each of calomel and James's powder, and, after an interval of three or four hours, by a sharp cathartic—as, for instance, the ordinary black draught. On the morning of the following day the remission will probably be more complete, when quinine should be freely and repeatedly administered. A mixture of antimonial wine with acetate of potash should also be given every two or three hours, so as to increase the action of the skin and kidneys. The patient must be carefully watched during the period of convalescence. A timely removal from all malarious influence, by a change of climate or a sea-voyage, is of the highest importance.