170 
MALARIA 
PER CENT OF TOTAL EXAMINATIONS SHOWING PARASITES 
RELATIVE 
INCIDENCE ( 
>F MALARIA INFECT 
IONS IN T.V. 
A. E 
MPL0 
YEES 
\ 
1 
A 
FALC 
IPAft 
UM 
I 
P. VI 
\ 
\ j 
'V 
°»J 
r 
I. 
J 
/ 
—^ 
V 
> 
•V 
\ 
1934 
»: 
J5 
19: 
36 
NUMBER OF 
EXAMINATIONS 
MADE 
4 AS 
514 
316 
!40 
445 
’396 
311 
607 
548 
93 
172 
232 
704 
341 
457 
440 
311 
340 
816 
852 
525 
621 
191 
73 
374 
520 
394 
369 
Fig. 1. Incidence of malaria infection during several consecutive years among employees of the Tennes¬ 
see Valley Authority. Active transmission of infection is to be inferred during the first year (1934) when 
P. falciparum dominated the picture. The rise in P. vivax in 1935 and 1936 is ascribable to the activation 
of infections acquired, in 1934. (Courtesy Health and Safety Division, Tennessee Valley Authority.) 
event it is difficult to determine the respon- Our series of seven cases of simultaneous 
sibility of either parasite alone in the con- inoculation was notable for the clinical 
tinuing illness (Fig. 2). activity of vivax in three patients more 
Fig. 2. Showing Clinical Attack Experienced by Patient 220-1085 Simultaneously Inoculated on May 
29, 1936, by 16 Quadrimaculatus Infected with P. vivax and 17 Quadrimaeulatus Infected with 
P. falciparum. 
The chart covers a period of observation of 156 days. The upper portion represents the tempera¬ 
ture eurve, the black bar& in the same portion represent the degree of splenomegaly observed. The 
lower portion with semilogarithmic ruling represents the daily parasite counts of each species of para¬ 
site per cubic millimeter, tlje lower line of which represents a count of 10 per cubic millimeter. 
The solid line in the lower portion represents the total falciparum count, the line of dashes the total 
count of gametocytes of this parasite. The line of dots represents the total count of P. vivax. Sporadic 
P. vivax axe represented by dots below the bottom line of the chart. 
The patient received two doses of 5 and 10 grains of quinine sulphate respectively on the 14th and 
16th days following inoculation and three doses of 10 grains on the 18th day. On the 66th and 67th 
days, three doses of 5 and 10 grains each were given. On the 90th day a single dose of 10 grains was 
given. No further quinine was given until the 143 rd day when he received three doses, one of 7 and 
two of 10 grains respectively. On the 147th day intensive quininization by Sinton’s method was begun 
and continued until the 154th day. (Am. Jour. Trop. Med., 17 (1937), 857.) 
