662 INFECTION AND IMMUNITY. 



sharply limited and a course with an irregularly 

 continuous (?) fever may be established. 



Quotidian malarial fever is caused either by 

 a double infection with tertian parasites or a 

 triple infection with quartan parasites. In either 

 instance a generation of parasites matures and 

 divides every twenty-four hours. The cause of 

 the double or triple infection is not known definite- 

 ly. In some instances it is possible that successive 

 inoculations by different mosquitoes has occurred. 

 On the other hand a fever which is primarily ter- 

 tian or quartan may gradually change into the 

 quotidian variety, and in this condition it is pos- 

 sible that the organisms may gradually separate 

 themselves into two or three distinct generations, 

 which reach maturity on successive days. 

 Mixed In other instances mixed infection with two 

 infections. kinds of parasites is encountered. This is usually 



aestivo-autumnal fever combined either with ter- 

 tian or with quartan. Either the aBstivo-autumnal 

 may be primary on the one hand or the tertian or 

 quartan on the other. The clinical course is com- 

 plicated correspondingly. It is doubtful if tertian 

 infection is ever mixed with quartan. Huge speaks 

 of experiments by Dr. Mattei which indicate that 

 a mixed infection does not continue indefinitely 

 as such. A patient suffering from quartan fever 

 was inoculated with aBstivo-autumnal blood; in 

 time all the quartan parasites disappeared, leav- 

 ing only the sestivo-autumnal. 



In malarial cachexia there is not only an in- 

 sufficiency of the blood-forming organs, but other 

 parenchymatous organs have suffered as a result 

 of prolonged intoxication. The blood-forming or- 



