238 



peratures may occur, due solely to the malignant 

 tertian parasite. Such charts are not at all uncommon 

 in first attacks in the tropics, and may be followed by 

 charts with regular curves. 



The malignant tertian parasite has a develop- 

 mental cycle of about forty-eight hours, and it seems 

 more likely that these irregular charts are produced by 

 an irregular irruption of young forms into the circula- 

 tion than that the parasite has a variable time of 

 development. If we suppose that young fission forms 

 exist in the internal organs, which come into the 

 circulation irregularly, then we should have still a 

 constant time of development, but an inconstant time 

 at which the development started. If, however, a 

 quotidian parasite exists, there should be no difficulty, 

 as we have stated above, in determining the fact by a 

 series of measurements at fixed intervals. 







ACTION OF QUININE 



Action of Quinine on Parasites. Quinine although 

 it does not prevent fission yet destroys the young 

 ring forms. 



As is well pointed out by Marchiafava and Bignami 

 the ensuing attack may still lack nothing in severity, 

 although parasites are exceedingly scanty. 



Although this may be considered as the typical 

 action of quinine, yet there are cases, as anybody who 

 has observed really severe cases of tropical fever, e.g., 

 in West Africa, well knows, in which quinine has not 

 always this inhibitory effect. 



In such cases the number of parasites may be 

 exceedingly small or even absent, and yet the severity 

 of the symptoms persist. To those cases where with 

 severe symptoms and yet an absence of parasites and 

 to those cases where other factors promote the rapid 



