PLASMODIUM MALARLA. 635 
particular change took place in the intracorpuscular 
tertian parasite while undergoing destruction by the 
specific. 
The following points, nevertheless, about the action 
of quinine on the parasites seem to be well established : 
First, that under its use the intracorpuscular varieties, 
whether tertian, quartan, or estivo-autumnal, rapidly 
disappear from the circulating blood; second, that 
quinine administered some hours before a paroxysm 
will not interrupt the cycle of their development, but 
will usually destroy the products of segmentation, and 
so check the succeeding paroxysm; third, that the cres- 
centic and ovoid bodies which develop in estivo- 
autumnal fevers are very slightly affected by the action 
of quinine. 
Mixed Infection in Malarial Fever. It is now a well- 
known fact that along with a malarial infection there 
may exist another due to the typhoid bacillus, to one 
of the pyogenic cocci, or to other micro-organisms. 
Such mixed infection may make a complete diagnosis 
a very difficult matter. 
Diagnosis. The diagnosis of malaria in all its forms 
has been greatly simplified by Laveran’s discovery. 
This is not a matter of so much importance in the 
simple typical intermittents, but in the atypical forms 
of the disease, and especially in pernicious malaria, the 
symptoms of which are readily overlooked, serious 
errors in diagnosis may be made. Moreover, par- 
oxysms of intermitting fever, which are common in 
other diseases, may be mistaken for those of malaria 
—such as occur in the early stages of tuberculosis, in 
ulcerative endocarditis, in suppuration associated with 
septicemia or pyemia, in pyelitis, etc. In all such 
