Medical Officers of the Army of India.
159
a similar abortive growth took place in the other milder cases after cessation of
pyrexia, and concurrent with the continued exhibition of quinine. The fact was
also elicited that in every one of these five cases there happened from 2 to 5 days
after the artificially induced crisis, a development of flagellated organisms in the
blood, either once or repeated at 2 or 3 days' intervals, after which the visible
blood-contamination might soon end. The total amount of quinine exhibited
in individual cases was from 60 to 280 grains : always 20 grains seemed enough to
stop the fever, after which events varied in detail. The above facts indicate
that whilst the alkaloid arrested the fever at once, it effects this by some special
agency not connected with the hæmatozoa in their visible aspect ; these bodies
still persisting unchanged for a time, after the cessation of pyrexia. I would
further note that the voracity of the blood phagocytes in their eager pur-
suit of the pigmented spheroids, flagellate and bare, seemed in no way im-
paired after full doses of quinine given by mouth, or by the sub-normal body-
temperature thereby often induced : indeed, it appeared as if evolution of the fla-
gellated stage had, as its accompaniment, an increased activity of the amæba; and
possibly the depurative action of the alkaloid might be explained by its stimu-
lating rather than paralysing the phagocytes. The empirical recommendations
to give quinine at certain hours before or after the febrile paroxysms of ague, or
during apyrexia on certain days of expected relapse, would receive both support
and explanation, were the hypothesis of a direct relation between organism and
paroxysm sufficiently established on other evidence ; but at Bombay it did not
seem that a relationship close enough to apply here could be maintained.
Pathogeny. —The following remarks are based on personal observation of
malarial disease, and of the analogous monad and spirillar infections of man
and animals. The organism of ague as above described, being morphologically
identical with that seen in the West ; its import, biological and clinical, would also
be recognisable here. Respecting parasitic blood-diseases even long investi-
gated, opinions often differ as to character, source, and properties of the organ-
isms concerned ; and as regards the malarial infection, studied anew, diver-
gence seems not less inevitable, with possibly some disturbance of general
views held as settled. Difficulties pertain especially, I think, to the character
of the parasite ( a), and to the complicated symptoms of its associated disease ( b) .
(a) A foreign organism belonging to the animal kingdom might, in the
vertebrate host, have effects different from those attending the common plant-
infections ; for, as remarked elsewhere, the hæmatophyta, as less germane, may be
less tolerated than hæmatozoa ; nor do I recollect any example of bacterial blood-
contamination so abundant and continuous, and yet so apparently harmless, as the
monad-infection of the common rat. This instance has been chosen for com-
parison, because an apparently identical infection of equines being highly viru-
lent, it serves to show that an infecting organism may be either pathogenous