_Symptoms._—These usually begin with a severe attack of shivering; the temperature rises rapidly, the pulse and breathing are greatly quickened, and the patient is completely prostrated. The face is flushed, the skin feels hot and dry, and there is a short cough, dry at first, but afterwards accompanied by expectoration of a moderate quantity of slimy, rust-coloured, blood-stained, and almost frothless matter. Usually there is pain on the affected side, which in most eases is the right side of the chest, above the liver. In African natives heart failure is very common. _Prophylaxis._—In order to prevent the occurrence of pneumonia amongst native followers good food should be provided, properly cooked; and it is important to see that they are supplied with sufficient blankets at night if travelling through cold regions. If it can possibly be avoided natives from hot, humid localities should not be taken to chilly, elevated and wind-swept places, as under such conditions they are very apt to contract pneumonia. Overcrowding in huts or tents should be avoided, and any sore throats which develop should be promptly treated. _Treatment._—A patient attacked with pneumonia should take to bed at once. The affected side should be surrounded with a _large_ poultice. Five grains of quinine should be given every eight hours. If the heart’s action is weak, give some preparation of ammonia, as a stimulant, and administer alcohol, up to half an ounce, every two hours. Opium should only be given to calm the patient, as large doses do harm by checking free expectoration; if there is much distress, then ten or fifteen grains of Dover’s powder may be given. An ice poultice applied to the chest will give great relief by lowering the temperature and diminishing the pain (_see_ page 274). _Quinsy, or Inflammation of the Tonsils._ Apply poultices to the neck. Gargle with a hot, weak solution of permanganate of potash, or a solution of chinosol (1 in 2000), at least every hour. Administer quinine and iron as a tonic. Keep the bowels well open. Surgical aid is sometimes required in bad cases. _Relapsing Fever._ This is the old “famine fever,” and it occurs in various parts of the world. _Causes._—It is due to a corkscrew-shaped blood parasite, which is conveyed from the sick to the healthy by means of lice. Some hold that certain forms of this fever in Palestine, Cilicia, and Persia are transmitted by means of the common fowl tick, which often harbours in the cracks in native bedsteads and in crevices in the walls of huts and other dwelling places. The true tick fever of Africa, which is also a relapsing fever, is considered separately. (See _Tick Fever_, p. 241.)