FILARIAL MIGRATIONS TO AND FROM THE CIRCULATION. 245 



the 18th and 19th August) thej are single, not quotidian, tertian, 

 or quartan. 



The first three compartments on the chart refer to Li-Kha (I.) ; 

 the second three to Tiong-Seng (II.) ; and the two lowest are oc- 

 cupied by readings of thermometer and barometer. At the margin 

 are numbers referring to number of filaria found, temperature of 

 body, beats of pulse per minute, &c., &c. Along the top the figures 

 refer to the date and the hour of the day. 



One or two things require a little explanation. The effect of the 

 febrile state is well known in the case of Tiong-Seng (II.). From 

 the 12th July, when systematic observation commenced, till the 

 afternoon of the 16th he was in his usual health, though his tem- 

 perature ranged rather high, and the filarial rhythm was perfect. 

 At one p.m. on the 16th, after being out of sorts all the morning, 

 he had a rigor, followed by rapid rise of temperature and smart 

 fever ; at four p.m. he took five grains of quinine ; by ten p.m. in- 

 flammation of the right tunica vaginalis, with effusion and perhaps 

 orchitis, declared itself, and the groin glands had become painful and 

 swollen. Next day he was quite confined to his bed, inflammation 

 continuing. He took three doses of quinine of five grains each 

 during the day. On the 18th fever and inflammation had subsided, 

 and he took only two doses of quinine. On the 19th the fever and 

 inflammation relapsed, and he had an attack of a sort of convulsive 

 hysteria ; that day he had three doses of quinine. On the 20th he 

 was better, and on the morning of the 21st was entirely free from 

 pain and fever. The swelling of the testicle and glands gradually 

 subsided. Contrast the behaviour of the thermometer and of the 

 embryos during and immediately after the attacks. The disturb- 

 ance in periodicity did not begin for some time after the thermometer 

 had risen, and it continued for days after the temperature had fallen 

 to the normal standard. My inference is that the mere elevation of 

 temperature has not j^er se any effect on the periodicity, it would 

 show at once were this the case ; chemical or other pathological 

 changes, consequent on the febrile state, have an effect, and, until 

 these changes are eliminated or subside, filarial rhythm is interfered 

 with. The effect of the fever seems to be to prolong the periods of 

 remission, to diminish the number circulating at the time of maxi- 

 mum, and prevent complete fuscation at any time. 



As the quimne taken during the attack might have had some 

 disturbing influence, I tried the effect of a large dose on Li-Kha 



JouuN. Q. M. C, No. 47. w 



