QUARTAN FEVER 139 



Hcemomenas prcecox, is noted by a marked irregularity 

 in its clinical symptoms. It usually sets in during 

 August, September, or October, and is attended by 

 much more serious results than are the regular inter- 

 mittent fevers. The pernicious or malignant form 

 of malaria, rarely seen in temperate climates, but 

 common in the tropics, is caused in many cases, 

 though perhaps not in all by the same parasite. 



From what has been above described, it is evident 

 that when once the parasite has obtained entrance to 

 the blood it may remain and multiply for years. The 

 parasite is, however, very susceptible to the poisonous 

 action of quinine, and this is especially the case at the 

 time when sporulation has just taken place and the 

 spores are being set free in the blood. Quinine seems 

 to have little or no effect on the organisms whilst they 

 are inside the blood-corpuscle, but shortly before the 

 paroxysm is due it should be administered. Quinine 

 is amongst the very few absolutely trustworthy 

 specifics known to medical science. It seems to have 

 been introduced into Europe in the year 1640 by the 

 Countess of Chinchon, a small town south-east of 

 Madrid. The Countess was Vice-Queen of Peru, and 

 in 1638 was cured of a tertian fever by the use of 

 Peruvian bark. Shortly afterwards she started for 

 Europe with a supply of the drug, but unfortunately 

 died on the voyage. About a hundred years later 

 Linnaeus named the plant after this lady, but acting 

 on erroneous information omitted the first ' h ' in the 

 name, and called the plant Cinchona. According to 

 some authorities the word 'quinine' is derived from 

 'quina,' the Spanish spelling of the Peruvian word 

 * kina/ which signified bark. 



But to come back to the parasite. It was mentioned 

 above that the amcebulae become either sporocytes or 

 gametocytes. We have followed the fate of the former 

 and must now turn our attention to the latter. In the 



