This comes on with pains in the head and back, aching in the joints, yawning, followed by coldness of the hands and feet, blueness of the nails and skin of the hands, general chilliness, sometimes "shaking." This lasts from a few minutes in some cases, to several hours in others. The chill is followed by a fever, which is generally severe and long continued, in proportion to the length and severity of the chill. The fever is followed by free perspiration, when it subsides and leaves the patient in a comfortable condition. This state is called the Intermission. This continues from a few hours to twenty-four, or longer, when another chill comes on followed by fever and sweats as before. During the chill and fever, the patient often suffers great pain, and is sometimes delirious. Young children frequently have convulsions when the chill sets in. These convulsions of children, though alarming, are not often dangerous.
TREATMENT.
As soon as the first symptoms of the chills appear, such as the headache, pain in the back and bones, coldness of the hands, nose and ears, give Aconite and Baptisia alternately, giving the first three doses every ten minutes, the next three doses every fifteen minutes, and then once in half an hour until the patient begins to sweat freely, when the medicines should be discontinued. If there is nausea or vomiting present, let the patient have lukewarm water freely in large draughts, until he vomits it up several times. As soon as the sweating commences, give Arsenicum and Macrotin alternately every hour during the intermission, except during sleeping time. On return of the chill, should it appear a second time, use the Aconite and Baptisia as before, and follow them with Arsenicum and Nux Vom. every two hours. This course of treatment will cure a majority of cases, but some require Cinchonia. That Cinchonia is a specific for intermittent fevers in many of their forms, no one will deny. It is the Homœopathic remedy for many cases, and should be prescribed. The injurious effects that are often attributed to Quinine, are, I have no doubt, attributable not to that remedy, but to the drugs that are used prior to giving the Chinium Sul. I have used it in more than two thousand cases, and have never been able to see any evil consequences follow its proper use. It should be given from the beginning of the chill to the end of the paroxysm, and continued during the whole time of the intermission: i. e. until the time arrives for the next chill, time being important in the use of this remedy. Use the first decimal trituration, and give grain doses (equal to 1-10th of a grain of the drug) every half hour till the time the next chill would occur, if it pursued its regular course, allowing the patient six or seven hours time in each twenty-four, for sleep.[1] Though from two to four grains of the pure Chinium Sulphuricum is all the patient would get, very few cases that do not yield to a course of the former treatment here recommended, will have the third paroxysm after this China treatment is commenced and pursued as here directed. For children the dose may be one-half or one-fourth that of the adults. If a trituration of the medicine cannot be got conveniently, four grains of the Quinine may be put into a four ounce vial of water, shaken well every time, and a teaspoonful taken at a dose. Abstinence from food as far as practicable, and quiet is of much importance in this disease, but the patient may use water freely.
In some cases, the chill is irregular and indistinct, the patient is thirsty during the chill, and the cold stage is long in proportion to the length of the fever, the surface pale and more or less bloated. Arsenicum is the remedy, and should be given from the commencement of the chill, and every hour until the fever subsides, then every three hours during the intermission. In chronic cases, where the patient has been drugged with mercurials and cathartics, together with larger doses of Quinine, and is still suffering under the disease, Pulsatilla and Macrotin in alternation, will, in nearly every case, effect a cure.
Bilious Fever.
This fever may be either intermittent, remitting, or continued, and typhoid. It is distinguished from common intermittent, by the great derangement of the stomach, as nausea and vomiting of bilious matter, yellow coated tongue, bitter taste in the mouth, foul breath, loss of appetite, high colored urine, and frequently distress and fullness in the right side, (though this last is not in every case present,) the skin and white of the eyes soon become yellowish, the chills are often imperfect, the fever being disproportionably long.
TREATMENT.
Podophyllin and Merc. should be given in ease of intermittents of this character, during the paroxysm, and in rotation with the other remedies for intermittents, giving a dose every three hours during the intermission. It is well also to continue these remedies night and morning, alternately, for a week or so, after the cessation of the chills and fever, or until all bilious appearances cease.
A Remitting Fever is one that goes nearly off, but not so entirely as an intermittent, returning again by a paroxysm of chill more or less distinct, sometimes hardly perceptible, and an increase of the fever following, from day to day, until arrested.