clinical entity, and which from its peculiar feature I would call double continued fever.
Since Crombie wrote, several observers have made important contributions to the subject, notably Thompstone and Bennett, who described under the name of hyperpyrexial fever what appears to be a special form of fever in West Africa; McCarrison, who has described a fever of three days' duration occurring in Chitral, and which is now identified as phlebotomus fever ; and Rogers, who has more recently described one of seven days' duration in Calcutta (p. 389).
Simple continued fever.— Simple continued fever generally, if not invariably, commences with a rigor, the temperature rapidly or more slowly mounting to 104°, 105°, or even 106° F. There are headache, malaise, a white furred tongue, anorexia, thirst, and perhaps vomiting. The fever lasts usually from three to eight days; occasionally it is prolonged for two, three, or four weeks. Crombie remarked that these cases are particularly common in towns, and were known locally as Bombay fever, Calcutta fever, and so forth. It might be suggested that such fevers are mild or aborted typhoid; but, in 'view of the absence of the characteristics of enteric, the insignificant mortality, and the freedom from complications, so grave a diagnosis does not seem to be justified. It is customary to attribute them to heat, chills, change of season, acclimatization, irregularities in diet, exposure to the sun, and the like. How far these etiological speculations are correct it is hard to say.
LOW fever— Like the preceding, this type of fever is not an unusual one among Europeans in the tropics. Its characteristics are indefinite duration— weeks or months; a persistent though slight rise of temperature, rarely above 101.5° F. but never below 99°; anorexia, debility, loss of flesh, and a tendency to bilious diarrhœa. It is unrelieved by quinine or arsenic ; but it almost invariably responds to a change of air, especially to a trip at sea.
Non-malarial remittent.— Crombie remarked that it is a pity we have no better name for this fever, which is of very frequent occurrence in India, and is
