489 
VII.  MALARIA  IN  JAMAICA 
Type  of  fever.  The  clinical  types  of  malaria  which  exist  in 
Jamaica  are  the  same  as  are  found  elsewhere,  but  so  far  as  my  short 
experience  showed  me,  they  are,  on  the  whole,  of  a  milder  character 
than  those  with  which  I  have  come  in  contact  on  the  West  Coast  of 
Africa  and  in  Mauritius.  But  the  severe  types  are  by  no  means 
infrequent ;  there  was  one  death  from  undoubted  Blackwater  Fever 
while  I  was  on  the  Island,  and  I  obtained  the  history  of  several  others. 
Bilious  Remittent  attacks  are  also  not  uncommon. 
I  examined  a  number  of  blood  films  taken  during  acute  attacks 
and  identified  both  the  parasites  of  the  malignant  tertian  (aestivo- 
autumnal  of  the  Italians)  and  of  benign  tertian.  I  was  unable  to  make 
a  systematic  examination  of  a  sufficient  number  of  the  films  to  come 
to  any  conclusion  as  to  the  proportion  of  the  different  parasites,  but 
I  have  to  thank  Dr.  Neish,  the  Medical  Superintendent  of  the  Leper 
Asylum,  who  has  made  special  investigations  into  this  subject,  for 
his  kindness  in  placing  his  figures  at  my  disposal. 
He  states :  '  I  have  examined  over  2,000  blood  films.  Up  to 
‘  1905,  I  have  classified  these; — the  number  was  1,636,  resulting  as 
‘  follows  :  — 
570  Benign  Tertian  72  Double  Infections. 
384  Aestivo-Autumnal 
79  Mixed 
1 5  Quartan 
588  Negative 
1,636 
'  All  the  cases  were  fever  and  as  far  as  could  be  ascertained  had 
‘  not  had  any  quinine.  A  large  proportion  of  the  negative  cases  had 
‘  well  marked  simple  tertian  symptoms,  but  there  were  no  parasites  in 
‘  the  peripheral  blood. 
‘  The  benign  tertian  predominates  after  the  October  rains,  the 
‘  aestivo-autumnal  during  June,  July  and  August. 
It  is  interesting  to  observe  the  considerable  pioportion  of  the 
malignant  infections,  in  view  of  the  fact  which  I  have  mentioned, 
I 
