Medical Officers of the Army of India.
45
instead of being large, pale and œdematous looking as in tertian, they were
reduced in size, dark coloured, and sometimes shrivelled and puckered ( fig. 4).
The above forms agree very closely in their characters and sequence of
development to the parasites found in simple tertian and quartan fevers, and
the assumption is unavoidable that, in this, as in the others, a parasite exists in
the blood, the period of whose development agrees with the clinical cycle of the
fever, and whose sporulation coincides with the febrile paroxysm.
In addition to these sporulating forms, however, other bodies were found,
which are characteristic of, and peculiar to, the fevers of this group, namely, the
bodies of the crescentic series. In Northern India, as in Europe, these bodies
assume three typical shapes, ( a) crescentic ( fig. 7 ); ( b ) fusiform or cigar-shaped
( fig. 8) and ( c) spherical ( figs. 10 to 13 ). When watched on the stage the
true crescents may frequently be seen to become spherical, and these in their
turn throw out flagella ( fig. 14). It is needless to enter into a minute descrip-
tion of the appearances of these bodies. They have been fully described by
all observers who have written on the subject from Laveran onwards, and have
received special attention from Mannaberg. The series of changes which they
undergo, in films under the microscope, after removal from the body, have been
most carefully and graphically described by Dr. Patrick Manson and Surgeon-
Major Ross, whose observations have been found to agree entirely with those,
witnessed by the writer. These bodies occur in the blood at any period of a
quotidian fever which has lasted more than a few days. and, like the spherical
forms of tertian and quartan, but to a much greater degree, resist the action of
quinine and persist after the disappearance of the spore-forming bodies.
(2) In Irregular and Remittent fevers.—Any, or all of the forms above
described may be found in the blood at any time during the course of the
disease. In the case of Haidar they were so numerous that, in some fields of
a Z e r i s s 1 / 1 2 t h w i t h a N o . 2 e y e - p i e c e , a s m a n y a s s e v e n b o d i e s o f t h e c r e s c e n t i c
series were found, while the average in each field of the films, made on the 15th
and 16th, was calculated to be four. In the same fields were numerous epi-
corpuscular young forms, and endo-corpuscular older forms at all stages up to
that of the collection of pigment in the centre a few sporing bodies were also
seen.
Structure of the Parasite of irregular and quotidian fevers. —When fixed
and stained in the manner above described, the parasites are found to have the
following structure :—The younger forms ( Pl. II., B, 1 to 6) stain bright sky
blue with a markedly chromophil grain in one part. Some are very distinctly
seen to be small irregular masses of cytoplasm with a projecting pseudopodic
process (1 ), others to be distinctly ring-shaped (2) ; others again to be irregular-
ly ring-shaped (3 to 5), while in certain cases two or more may be found in one
cell (6). Slightly older parasites contain a few grains of melanin ( 7 to 10 ) ,