CHAPTER XXIII
IMPERFECTLY DIFFERENTIATED FEVERS OF THE TROPICS
THERE can be little doubt that in the tropics there are a number of fevers specifically distinct from any of the foregoing, and also from the better-known fevers of temperate climates. Such fevers are constantly met with and are a perpetual puzzle to the conscientious diagnostician; and, up to the present, little of a truly scientific character has been done towards describing, separating, and classifying them. Some attempts have been made to arrange these imperfectly differentiated fevers on a clinical basis; but, until their causes have been discovered and, above all, until they have been studied in reference to any possible connection they may have with the known pathogenic tropical parasites, anything like a sound classification and description has to be postponed. So far as known, they are not associated with distinctive exanthems or even with distinctive visceral lesions; a circumstance which has contributed, doubtless, to retard our knowledge in a very important department of tropical medicine.
The late Colonel Crombie, I.M.S., attempted a classification of these fevers on a clinical basis, which, so far as it goes, is of distinct value. His remarks apply solely to the fevers of India; but I can recognize in his descriptions clinical forms which I frequently met with formerly in China. It is fair to infer from this latter circumstance that, if these fevers are found in India and China, they probably occur also in other warm countries.
Crombie divided them into simple continued fever, low fever, and non-malarial remittent. To these I would add yet another, which, from experience in China, I regard as a distinct
