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Scientific Memoirs by

to 5 grains for eight days, the man begged discharge(cured)twenty days after the last febrile
paroxysm, and 40 after admission. At first, the area of splenic dulness measured about
5 square inches, finally becoming nearly normal.

     The blood was examined on twenty-six days, viz., about dates of every relapse, also
during the apyretic intervals, and often subsequent to the latest paroxysm seen. At febrile
periods, pigmented spheroids, both sessile and free, became numerous with the onset of
fever, the free organisms breaking up and dispersing during and after the acme of
pyrexia; and at apyretic intervals, only some pigmented leucocytes might be seen in the
blood. At no time, in this case, were the crescentic bodies found; but on the third day,
after the last paroxysm of fever (quinine previously given), I detected active, flagellated
spherules in the blood (t. 98˚) at 9 A.M; at 1-45 P.M., only a few bare spheroids, so at
2-15 P.M., and again at 6 P.M., as well as on the following morning; after which date,
for fourteen days longer, the blood remained free from visible contamination, except as indi-
cated by scanty brown and blue pigment granules free. It was noted that at change of
date of paroxysm under the influence of arsenic, a few spherules appeared in the blood
about the time of expected febrile relapse, yet without the concurrence of any rise in
temperature.

     2.Quotidian ague.—C. A., Frenchman, æt. 26, country-born, an engineer's assistant,
contracted ague whilst engaged on reclamation-works at Singapore about a year since
(1886), and was obliged to leave: subsequently, in India, he had no return of the fever,
until June last, whilst ondeck-passage (bad weather) to Bombay. Resorting to an hospital,
his illness was soon arrested here by quinine, but, again returning, he entered the J. J.
Hospital, where in my ward a series of eleven daily paroxysms were watched (max.
t. 102-3˚; F.), until checked by quinine (20 grs.); after which no return for fifteen days
(quinine in smaller doses), and also outside hospital for another period of ten days without
medicine. The spleen was at first distinctly enlarged, the dulness-area measuring 5 inches
by 8 inches—though not markedly tender: it soon after subsided. The man's health im-
proved considerably in hospital.

     The blood displayed numerous pigmented crescents, with a few spherules, on his
admission and many times subsequently, both during and after the febrile manifestations;
the organisms finally becoming fewer, though with care detectible until the last day of his
stay in hospital: and, in addition, I detected on the fourth day after arrest of fever (t.
98˚;) several active flagellate bodies, which were again seen upon several occasions
until the end. These organisms were, with the patient, shown at the September meeting
of the local medical society and freely recognised by members present. The patient could
not be induced to remain longer than a month, and on two subsequent visits he made I did
not perceive any organisms in the blood.

     3. Quotidian (? remittent) fever; intercurrent paroxysms.— A.I., Mussulman, æt. 20, a
dock labourer, born and resident in Bombay, had fever seemingly paroxysmal for twelve
days, which spontaneously subsided the day after his admission (August), when t. 101.4˚
and diaphoretics alone given. The spleen was then a little enlarged, but not tender. Quassia
was given, and after ten days complete apyrexia a series of smart intermittent paroxysms
spontaneously began, the first three being of tertian and the last three of quotidian type,
(max. t. 104˚; to 105.2˚;): quinine was then administered in three 10-grain doses, and the
fever became forthwith arrested; there being no recurrence during the twenty-two days of
his further stay in hospital, during which time the cinchona alkaloids alone were exhibited.

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