[ IO ] 
action of Quinine dissolved in the blood serum on the parasites. The result 
of giving large doses where small doses fail and even increasing both the 
frequency and the amount of the doses in severe cases almost to an unlimited 
extent is usually found to be highly satisfactory. In two of the fatal cases 
intramuscular injections of 5 grains were given every two in one case and 
e\ ery 3 hours in the other on the day on which death occurred. 
Coma was not present in all the fatal cases; death in several seemed 
to be the result of collapse or slow cardiac failure. 
Intense congestion of the alimentary tract was present in three cases 
and in one other, though neither ulceration nor marked congestion was found 
at the autopsy blood had been passed per rectum in quantities two days 
before death. The frequency of Epistaxis in Malaria is well known. 
The two organs most commonly enlarged in Malaria are the liver and 
spleen. In these cases the average weight of the spleen was 476 grams., in 
two cases it was under 300 grams., and in three under 400; in two it was 
o\ er /oo, in one o\ er 600, and in four over 5°°* As the normal weight 
paries from 150 to 250 grams., it will be seen that the enlargement was slight 
m two and moderate in three more and in none extreme. 
As compared with the cases of Enteric occurring in the same race, 
Chinese, there is littie difference, as in these the average weight was 380, 
one of the spleens being only 190 grams. The others were respectively 270, 
435 and 635 grams. 
In the malaria cases the average weight of the liver was 1,568 grams., 
or little abo\ e the average normal weight, and in only four was it over 
1,800 grams., two w r ere under 1,200 grams. 
The enlargement of the liver is far less marked than in Pneumonia, but 
slightly more than in the Enteric cases here, as these had an average weight 
of 1,505 grams. 
There were no cases of Haemoglobinuric (Blackwater) Fever, even 
fi om the intensely malarial Gombak district. At Klang, near the coast, one 
case w^as reported by Dr. \\ atson. The course of the disease and the 
character of the urine were similar to those in a mild attack of Blackwater 
Fever in Africa. 
. The so-called Eeishman Donovan bodies were not observed. No cases 
clinically resembling the disease associated with these parasites were 
seen by me. 
I am informed that amongst Tamil immigrants cases do occur with the 
association of enlarged liver and spleen and irregular pyrexia unaffected by 
Quinine. These have not been seen by me or examined for these bodies. 
Piroplasmosis. 
The most important of the sporozoa affecting the lower animals here is 
the Piroplasma Bigcminum. In 4 out of 13 Siamese cattle convalescent from 
Rinderpest these were found, but in very small numbers. 
Subsequently Dr. Leicester made a larger series of examinations and 
found as follows :— 
