Malaria 95 



from those of the fevers here mentioned that they 

 cannot usually be recognized as the product of any 

 one of the malaria parasites with which we are 

 familiar. They also differ from one another so mark- 

 edly in their clinical manifestations that they may 

 be regarded as entities. 



Benign malaria has two species of parasites: tertian 

 and quartan ; in the former the fever recurs every two 

 days, in the latter every three days. If the chills 

 come every day it signifies that in a tertian case there 

 has been a reinfection on an alternate day. As the 

 parasites develop at a constant rate, the two sets 

 sporulate twenty-four hours apart, the liberation of 

 the spores and toxins into the blood causing the chill. 

 It is during the chill that the action of quinine is most 

 effective, the organisms being unprotected by the 

 walls of the corpuscles. 



Malignant malaria (estivo-autumnal fever, hemor- 

 rhagica, tropical malaria, congestive malaria, etc.) has 

 three species of parasites: pigmented quotidian, un- 

 pigmented quotidian, and sub-tertian. In congestive 

 malaria the fact that the organisms throng the kidneys, 

 liver, brain, and spleen, while in the other forms the 

 parasites live in the red blood corpuscles, would, in 

 itself, indicate that these were a different species from 

 the protozoa of the benign infections. 



Relation of Parasite to Intermediate Host. — 



Dr. Miajiama, of Tokio, seems to have shown that 

 there are certain species of mosquitoes capable of 

 conveying only one species of malaria parasite. In 

 Japan proper, he declares, only one kind of malaria 

 (tertian) and only one species of Anopheles (sinensis) 



