. A practical study of malaria. g on successive days, give rise to quotidian fever. Asin simple tertian intermittents, quartan accesses sometimesanticipate or retard. Subintrance in triple infections is rarelyseen, due probably to the shorter duration of the of type between single, double, and triple quartan aresometimes observed. The onset, especially in single infections, occurs probablymore often during the afternoon hours. The symptoms are 190 THE STUDY OF MALARIA those of the typic paroxysm and are well marked. The coldstage is not only more constant than in the other fo
. A practical study of malaria. g on successive days, give rise to quotidian fever. Asin simple tertian intermittents, quartan accesses sometimesanticipate or retard. Subintrance in triple infections is rarelyseen, due probably to the shorter duration of the of type between single, double, and triple quartan aresometimes observed. The onset, especially in single infections, occurs probablymore often during the afternoon hours. The symptoms are 190 THE STUDY OF MALARIA those of the typic paroxysm and are well marked. The coldstage is not only more constant than in the other forms, but ismore intense and usually of longer duration. The three stagesare sharply contrasted. Pernicious symptoms are very rarelyobserved in connection with quartan infections. This may beaccounted for by the more equal distribution through the circu-lation of the parasites which show no tendency to congregate,and by the longer apyrexial periods between the average duration of the paroxysm is eight or ten Fig- 55-—Triple quartan infection. The obstinate disposition of quartan fever to recur has beena matter of common knowledge for centuries, and is still apopular idea. This may doubtless be accounted for at this dayby the probability that, owing to the greater interval betweenthe accesses, the specific is not properly taken. Most physicianswill agree that quartan fever is just as amenable to appropriatetherapy as the other acute forms. As in tertian fever, analmost complete feeling of well being may be experienced be-tween paroxysms, the patient usually being able to attend tobusiness. Estivo-autumnal Infection.—The chief feature of infec- CLINICAL HISTORY I9I tion with estivo-autumnal parasites is the irregularity of thecourse as contrasted with that of tertian and quartan infec-tions. A classification is difficult and, while that into estivo-autumnal or malignant tertian and quotidian is perhaps best,these may be clinically indistinguishable. Malig
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectmalaria, bookyear1909
