MALARIA. 381 



their secondary form, the spindle-shaped (cigar-shaped) 

 bodies and the spheres. With regard to the nature of the 

 connection between these forms and the ameboid parasite 

 there is as yet no unanimity of opinion. The various views 

 with regard to the source and the destiny of the crescents 

 have already been briefly outlined (p. 376). 



The quotidian parasite gives rise to typical quotidian 

 fever, and, when present in several generations, to continued^ 

 or irregular, fever. The fever induced by the quotidian 

 parasite differs clinically from that due to the tertian and 

 quartan parasites in its malignancy. It recurs obstinately, 

 and often gives rise to profound anemia, and to other per- 

 nicious manifestations (diarrhea, cachexia, coma, etc.). The 

 recurrences take place usually from seven to fourteen days 

 after the first febrile paroxysm. The crescents are generally 

 held responsible for the recurrences. These parasites are 

 present in the blood in the afebrile interval, and are believed 

 to be capable, through segmentation or true spore -formation, 

 of giving rise to new ameboid forms. The new paroxysms 

 would, thus, not be true recurrences, but, as Golgi believes, 

 only the expression of a type with long intervals. This is 

 denied by others, and the crescents are considered to be 

 only degenerative forms that are incapable of contributing 

 further to the formation of new individuals. It is true that 

 with the presence exclusively of crescents and their spheres 

 in the blood, fever is generally not present. On the other 

 hand, the demonstration of these bodies in the blood indi- 

 cates with certainty that fever existed a short while previ- 

 ously, and with great probability that new paroxysms will 

 occur within a short time. 



It is to be mentioned, finally, that there is an unpig- 

 mented quotidian parasite (Marchiafava and Celli), which is 

 distinguished from the ordinary quotidian parasite only 

 by the complete absence of pigment. This parasite, like- 

 wise, forms crescents, but these are unsupplied with pig- 

 ment. The clinical course of the infection with these 

 unpigmented parasites is in no wise different from that de- 

 scribed for infection with the pigmented quotidian para- 

 site. 



4.. The malignant tertian parasite has been separated by 

 Marchiafava and Bignami as a special species. It stands 

 close to the quotidian parasite, but is believed to differ 

 from this in the fact that its cycle of development occupies 



