530 
noted that the chromatin of the nuclei in the two parasites is separate and 
that the union begins in the protoplasm of the organism. In the second 
stage, which may be designated as that of complete protoplasmic union, 
the chromatin masses become situated in the protoplasm of one organism 
which is formed by the union of that from the two. In the third stage, 
or the one of chromatic union, the two chromatin masses become united 
and form one large mass situated within the hyaline ring. Sometimes 
the union of the latter appears to be preceded by the loss of a small 
particle of chromatin from one of the masses. Briefly stated, intracorpus- 
cular conjugation consists in the union, at some portion of the peripheral 
protoplasm, of two hyaline plasmodia, the two chromatin granules remain- 
ing separate; gradually the protoplasm of the two organisms unites, this 
union being followed by that of the chromatin masses and of the 
achromatic substance of the nuclei; conjugation is thus completed, the 
union being permanent and occurring within the erythrocytes. 
The significance of the process.—Intracorpuscular conjugation is pres- 
ent in infections caused by all of the species of malarial plasmodia, 
namely, in the tertian, quartan, and estivo-autumnal varieties. In order 
to understand the significance of the process it is necessary to observe in 
what type of malarial infection it occurs, whether or no it produces any 
peculiar clinical manifestations, and whether it is always present or is 
a rare phenomenon. From my studies, during which I have examined 
hundreds of specimens of blood from patients suffering from acute initial 
attacks of malaria, recurrent attacks and latent malarial infections with 
reference to this process, the following conclusions may be drawn : 
First. Intracorpuscular conjugation is invariably present‘in every acute, 
initial attack of malarial infection, no matter whether it be due to the 
tertian, quartan, or wstivo-autumnal plasmodium. It is often difficult 
to demonstrate conjugating parasites, but repeated examinations will 
always result successfully. 
Second. This process is present in the vast majority of instances of 
recurrent malarial infection caused by any of the species of malarial 
plasmodium. 
Third. It is almost never present in latent malarial infection, the only 
eases in which it is noted being those which develop clinical symptoms 
within a day or two of the time of observation. 
Fourth. The process of intracorpuscular conjugation has, in the vast 
majority of cases, a direct relationship to the severity of the clinical 
symptoms. When the latter are most severe, the number of conjugating 
plasmodia is greatest; in acute, initial attacks the conjugating plasmodia 
are always more numerous than in recurrent ones, unless the latter are 
of a severe character. 
Fifth. The process is most easily observed in pernicious malarial infec- 
tions, for in such the conjugating plasmodia are most numerous. 
