The malignant typhus is rare at Zanzibar: it raged, however, amongst the crew of a French ship wrecked on the northern end of the island, when the men were long exposed to privations and over-fatigue. Intermittents (ague and fever) are common as colds in England. They are mild and easily treated;[47] but they leave behind during convalescence a dejection and a debility wholly incommensurate with the apparent insignificance of the attack, and often a periodical neuralgia, which must be treated with tonics, quinine, and chiretta. The bilious remittent is, par excellence, the fever of the country, and every stranger must expect a ‘seasoning’ attack. It was inordinately fatal in the days when, the lancet being used to combat inflammation, the action of the heart was never restored. Our grandfathers, however, bled every one for everything, and for nothing: there were old ladies who showed great skill in ‘blooding’ cats. In 1857 men had escaped this scientific form of sudden death, but the preventive treatment so ably used on the West coast of Africa had not been tried. The cure at Zanzibar was an aperient of calomel and jalap. Castor oil was avoided as apt to cause nausea. Quinine was administered, but often in quantities not sufficient to induce the necessary chinchonization, and the inexperienced awaited too long the period of remission, administering the drug only during the intervals. Diaphoretics of nitrate of potash, camphor mixture, and the liquor acet. ammon. were used to reduce the temperature of the skin. The most distressing symptom, ejection of bile, was opposed by saline drinks, effervescing draughts, diluted prussic acid, a mustard plaister, or a blister. The hair was shaved or closely cut, and evaporating lotions were applied to the head. The extreme restlessness of the patient often called for a timid narcotic; in these days, however, the invaluable hydrate of chloral, Sumbul and chlorodyne were unknown, and soporifics were used, as it were under protest, being believed to cause constipation. Extreme exhaustion was not vigorously attacked with medical and other stimulants; and thus many sank under the want of ammonia and wine. I have since remarked the same errors of treatment in the West African coast; the patient was often restricted to the acidity-breeding rice water, arrowroot, and similar ‘slops.’ When he pined for brandy and beef-tea, the safe plan of consulting his instincts was carefully ignored. In strong constitutions the initiatory attack of remittents is followed after a time by the normal intermittent, and the traveller may then consider himself tolerably safe. In some Indian cases ague and fever have recurred regularly for a whole year after the bilious remittent.