158 N. J. Mosquito Extermination Association 



blood some pigmented red cells; that is all he said; therefore they 

 were malaria parasites. The patients got well, or at least got well 

 under quinine. A case of malaria in a temperate zone, especially 

 tertiary malaria, will not yield quickly, in three or four days, on 

 quinine, and you must make a proper diagnosis, and malaria is very 

 rare. And when you find cases that are diagnosed as malaria and 

 treated with quinine, they do not get well with quinine, they do not 

 respond to quinine. That is, I am speaking of tertiary. That is 

 what we have in those conditions, imported from some tropical coun- 

 try. Those cases always respond to treatment. We do have a cer- 

 tain number of old tertiary malaria. There are very few cases that 

 come from below the Mason and Dixon line or the tropics. They are 

 very rare. 



Malaria is a peculiar disease. It is a very peculiar disease. It is 

 a disease which has a marked latency. One will go down with an 

 attack of acute malaria and they will have chills and fever in this 

 particular type twenty-four or forty-eight hours and sometimes two 

 sets, and sometimes you will get a chill every other day. Then the 

 quaternary type get it every third day. It is almost impossible to 

 distinguish them sometimes without the presence of the plasmodium 

 in the blood. 



Now those things have all been worked out, and as I vSay, the 

 malaria in this part of the country responds to quinine. Now there 

 are many other diseases. Only the other day in my service in the 

 hospital where I happen to be attending physician, three of the local 

 men, some of the best men we have, made a. diagnosis of malaria. 

 The patient had fever and chills. At four o'clock every day the 

 patient had a chill, showed 105, and then six or seven hours after 

 in the day he would go down to 97, normal. I couldn't tell myself 

 by looking at it that it was quaternary malaria, but the blood showed 

 it was not. So it didn't prove to be malaria. But I say we have to 

 be very careful in predicating malaria in the sense in which we are 

 going to fight an epidemic or wipe out a pest, unless we are sure 

 we have got malaria. 



Now I think that Mr. Bowen's figures on this matter are all out of 

 proportion, to my conception of the morbidity rate of tertiary malaria, 

 absolutely. And every time those figures are published it always 

 seems to me it is a kind of reproach to the medical profession, that 

 they are not more careful in the diagnosis. 



But I do not like the mortality rates there. I know about this 

 epidemic in Princeton and I know all about this epidemic in Frank- 



