The diseases of infants and children . xamination showed enlarged spleen and parasites in blood. Attacks controlledby 20 grains () of quinine by mouth and 10 grains (.048) by suppository given on12th. Previous small doses without effect. 506 THE DISEASES OF CHILDREN The second stage of the paroxysms is graduallj replaced by thethird, or sweating stage, in which all the uncomfortable symptoms offever disappear and the temperature rapidly returns to normal. Theamount of sweating is very variable. Comfortable sleep usually total duration of the paroxj^sm averages G to 12 hours. A
The diseases of infants and children . xamination showed enlarged spleen and parasites in blood. Attacks controlledby 20 grains () of quinine by mouth and 10 grains (.048) by suppository given on12th. Previous small doses without effect. 506 THE DISEASES OF CHILDREN The second stage of the paroxysms is graduallj replaced by thethird, or sweating stage, in which all the uncomfortable symptoms offever disappear and the temperature rapidly returns to normal. Theamount of sweating is very variable. Comfortable sleep usually total duration of the paroxj^sm averages G to 12 hours. After theparoxysm the patient usually feels entirely well until the next one occurs,the length of the interval depending upon the type of malaria present. The urine in malaria frequently exhibits albumin in moderate may often be scanty just before the chill and increase during and afterthe paroxysm. The blood exhibits besides the parasites, a very decidedand rapidly developing anemia in cases which have had several Fig. 158.—Malaria, G., aged 16 years. Tertian fever a year before. Chills at intervals for over ayear. Blood showed typical quartan bodies. Spleen much enlarged. (Thayer & Hewelt-sons Malarial Fevers of Baltimore.) Leucocytosis is rare in malaria, but a relative increase of the largemononuclear cells is considered characteristic by some leucocytes often contain pigment-granules. Instead of beginning at almost the same hour on the days of theattacks, which is the rule in malaria, the paroxysms sometimes antici-pate slightly, occurring from 1 to several hours before the full periodhas elapsed (Fig. 156.) Under treatment with quinine postponementof the paroxysms for some hours is sometimes observed. The description of the symptoms as given apphes to the intermittentform of the disease and as occurring in older children. In man}^ instances,however, especially in tropical chinates or in young children anywhere,mala
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