33 
(but it is difficult to get this staining effect) a charac¬ 
teristic coarse stippling quite different from that of 
the simple tertian. These consist of a few coarse dots 
or clefts around the parasite (Plate I, fig. 4).* 
The finding of crescents is, of course, diagnostic 
of malignant tertian, but the possibility of a double 
infection, e.g ., simple and malignant tertian, must be 
borne in mind. 
Simple Tertian. —1. Characteristic is the fact that 
the infected red cell is distinctly larger than usual. 
2. Characteristic also is the fact that the red cell; is 
dotted all over with fine red granules (Schiiffner’s dots). 
Young forms as well as old produce this change in the 
red cell in a well-stained specimen, not overwashed. 
3. The young rings are larger and more flimsy¬ 
looking than the previous. Pigment may be seen ; 
it must be noted, however, that pigment is often 
obscured by Romanowsky stains. 4. The large forms 
are pigmented, irregular, flimsy-looking, and appear 
often as if consisting of two separate parts. This 
irregularity is characteristic (Plate I). 
Quartan. —1. The red cell is unchanged. 2. The 
rings are compact, not irregular, and shew pigment 
early, but the diagnosis of the species of young rings is 
very difficult. 3. Larger forms are compact, and 
characterized by the peculiar dense nature of the 
chromatin, which is, relative to the size of the cell, 
plentiful. 4. Pigment often occurs as a dense streak 
along the margin. These parasites once seen are easily 
recognized again (Plate I). 
We have so far described the forms generally 
encountered during a febrile attack and the means of 
making a diagnosis, but it is necessary to consider 
other forms, e.g., the sporulating forms, and more 
especially the gametes. 
D 
