238 
peratures may occur, due solely to the malignant 
tertian parasite. Such, charts are not at all uncommon 
in first attacks in the tropics, and may be followed by 
charts with regular curves. 
The malignant tertian parasite has a develop¬ 
mental cycle of about forty-eight hours, and it seems 
more likely that these irregular charts are produced by 
an irregular irruption of young forms into the circula¬ 
tion than that the parasite has a variable time of 
development. If we suppose that young fission forms 
exist in the internal organs, which come into the 
circulation irregularly, then we should have still a 
constant time of development, but an inconstant time 
at which the development started. If, however, a 
quotidian parasite exists, there should be no difficulty, 
as we have stated above, in determining the fact by a 
series of measurements at fixed intervals. 
Action of Quinine 
Action of Quinine on Parasites .—Quinine although 
it does not prevent fission yet destroys the young 
ring forms. 
As is well pointed out by Marchiafava and Bignami 
the ensuing attack may still lack nothing in severity, 
although parasites are exceedingly scanty. 
Although this may be considered as the typical 
action of quinine, yet there are cases, as anybody who 
has observed really severe cases of tropical fever, e.g., 
in West Africa, well knows, in which quinine has not 
always this inhibitory effect. 
In such cases the number of parasites may be 
exceedingly small or even absent, and yet the severity 
of the symptoms persist. To those cases where with 
severe symptoms and yet an absence of parasites and 
to those cases where other factors promote the rapid 
