DISCUSSION. 245 



of marines at the Naval Hospital in Washington, who had never been 

 infected in Panama, and in which blood there were large numbers of 

 gametes, no appearances which would indicate parthenogenetic division 

 were noted. Within the past few months I have observed at Cahacao 

 Naval Hospital a case in which there had been repeated attacks of malaria 

 covering a period of one year. Upon examining the blood of this in- 

 dividual, numerous macrogametes were observed but no schizonts. A 

 few days later parasites resembling Schaudinn's diagram of partheno- 

 genesis were observed, and a few days later the man had a typical malarial 

 paroxysm and in his blood numerous nonsexual macrogametes were 

 visible, and as the microscopic appearance of the parasites showing 

 sporulation, differed from that of the ordinary merocyte I was convinced 

 that the phenomenon I observed was that of parthenogenesis of Plasmo- 

 dium vivax. 



Dr. H. M. Neeb. — I wish to add to my paper that fig. 5 is given in 

 the work of Professor Euge. The difference between fig. 5 of my paper 

 and Ruge's is that Euge gives a figure of a red blood cell in which are to 

 be seen two parasites — one is a segmenting tertian parasite,, .the other 

 next to it is a gamete. But in my plate a protoplasmic band combines 

 both halves of this parasite. I can also absolutely state that this figure 

 represents one parasite, and not a mixed infection of the red blood cell. 



DISCUSSION ON THE PAPER, "MALARIAL FEVER DURING 

 THE PUERPER1UM," BY DOCTOR ATKINSON. 



Dr. Aldo Castellani, professor of tropical medicine and lecturer on 

 dermatology, Ceylon Medical College, delegate from the Government of 

 Ceylon. — I quite agree with Doctor Atkinson that in a malarial country 

 quinine should be given to pregnant women. This is the rule I always 

 follow in those districts of Ceylon where there is malaria, giving 5 grains 

 (0.3 gram) every day and 10 grains (0.6 gram) once a week. Lately 

 I have frequently used euquinine, which is said to have less action on 

 the uterus than the ordinary preparation of quinine. 



I also agree with Doctor Atkinson when he says that in malignant 

 malaria larger doses of quinine must be given. It is probable that in 

 a temperate zone 1 gram (15 grains) a day is sufficient to stop an infec- 

 tion with malignant malaria, but in tropical countries, like East Central 

 Africa and Ceylon, I find that much larger doses must be given. In 

 some cases 2 to 2.6 grams 30 or 40 and more grains a day are often 

 necessary. 



Doctor Atkinson. — I was not aware that euquinine had less effect on 

 the uterine muscles than quinine. We always give euquinine to children 



94547 — — 7 



