300 



with its preliminary pseudo- crisis, is lost. The 

 attack instead of lasting about a day lasts a few 

 hours only, as in the simple tertian, and instead 

 of a pseudo-crisis there is a true crisis, but the 

 young parasites, as in the malignant tertian attack, 

 are still coming into the circulation, and there 

 follows a rise which replaces the apyretic day in 

 the ordinary malignant tertian. 



According to Maurer, in the case of the 

 quotidian chart produced by one generation of 

 malignant tertian parasites we have the febrile 

 attack produced by the division of the majority 

 of the segmenting forms, and then a fall to normal 

 occurs ; when, however, there is a sufficient 

 accumulation of young forms arising from the 

 same generation there is again a rise giving the 

 quotidian chart. As we have seen, the young 

 forms of the malignant tertian parasite persist 

 during the pyrexia. If, however, by any means 

 they are destroyed or cease appearing temporarily 

 during the day of pyrexia, we should get a fall to 

 normal, and then as soon as this inhibiting cause 

 was removed, again a rise, giving a quotidian chart 

 produced by the malignant tertian parasite. 



Irregular Temperatures 



Besides the typical malignant tertian tem- 

 perature chart and the quotidian chart, various 

 irregular temperatures 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 



