339 
young asexual forms. Recently observ ations on these lines have been 
undertaken by me which will be published at ;i future date. 
Recently a case of crescents with rings has been put on quinine 
gr. 30 per day till no rings could be detected. After that the 
quinine has been stopped, and blood smears and drops have been 
examined at short intervals to see whether the crescents can diminish 
without the administration of quinine. The annexed Table ‘D’ 
shows that there is a natural tendency for crescents to diminish even 
when no quinine is administered. The patient has no fever. Liver 
and spleen are both moderately enlarged. The patient has symptoms 
of dyspepsia, general debility and irritability of temper. This latter 
characteristic has been often noticed in crescent cases. The drops 
show'a large and varying number of crescents, although when counted 
in smears one does not come across such marked differences. This 
shows that the counting of the smears is not a correct guide for the 
actual number of crescents in the blood. The diameter of each drop 
was between 8 and 9 mm., and the crescents were counted in these 
at an interval of a few days.* 
Table A 
No. of days that the crescents 
took to disappear from the blood 
when examined in drops 
No. of cases 
treated with 
picric acid 
No. of cases 
where no picric 
acid was given 
Remarks 
Less than 10 days 
r 
Between 10 and 20 days 
7 
4 
t3 incomplete 
” 20 » 30 „ 
7 
4 
ti „ 
» 3° i) 40 „ 
1 
7 
1 died on 34th day 
” 40 „ So „ 
0 
0 
» 5° >, 60 „ 
0 
0 
60 days and over 
ll 
1 
In Table D it will be noticed that the number of crescents in the drops on the first occasion 
" a> very great, and that on the third day there has been a sudden fall, which was kept 
“P* a cert: >in extent in subsequent counts also. Quinine administration was stopped on the 
V ,^ e P tem .* 5cr 5 I 9 lo > and since then none has been given. Is it likely that quinine actually retards 
5 c destruction of crescents hv lowering phagocytic activity ? This is a question worth considering 
*n future observations. ' ' 
t These cases absconded with crescents in their blood, and the results could not be completely 
ascertained. 
* My notes on this case arc :—Total quantity of quinine given, 915 grains. Total quantity 
0 picric acid by mouth, 182 grains. Patients hardly ever swallowed these medicines. In spite 
°. the qwaine, rings were found in the blood a month after the commencement of treatment, this 
circumstance being accounted for by the drug not having been taken properly. Injections of 
picrate of soda were therefore commenced. Ten injections were given, one on every alternate 
ay in all 30 c.c. of a 4 per cent, solution, i.c.. 18 grains of the acid were used during a period of 
da . v ^ 29th December, 1909, to 19th January. 1910). Crescents disappeared in 29 days 
er the first injection, and thev were present altogether for exactly two months. 
