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 88 THE INDIAN MEDICAL GAZETTE.

(Mar. 1904.

Now 1 have given you this account as a description of type parasites. You must not conclude that the types are rigid and unalterable —far from it,—but by paying attention to the points I have mentioned you will be able to decide by seeing what type the majority of the parasites in any given specimen resemble.

You will, however, frequently find malignant parasites which have their chromatin well away from the edge and of a regular globular shape, just as you will often see an Arab horse with a goose-rump and low-set tail. Still, by paying attention to the characters I have indicated, you will make as few mistakes in classifying the parasite as a horse-dealer will in classifying a horse.

The Chairman has asked me to explain the term “Flagellar Fever.” This term is the invention of Major A. Buchanan, 1m8., and I think up to date he monopolises the use of his invention.

In observing untreated the natural course of an infection with the summer-autumn parasite, rings and rings only will be found in the blood for the first few days while the fever lasts. From the end of the fever up to the seventh or eighth day no parasites whatever are observed in the blood. About the seventh or eighth day crescents begin to appear, and at first are slow to flagellate, being sexually immature.

As a rule there is a relapse of the fever about the end of a fortnight from the onset. This fever is accompanied and caused by the presence of rings in the peripheral blood. At this time also the crescents reach their maturity and are therefore quick to flagellate on withdrawing the blood from the body.

Major Buchanan and his assistants observing this flagellation, jumped to the conclusion that the same phenomenon occurred inside the human body. They also failed to observe any rings in the blood. He, therefore, concluded that the fever must be caused by this flagellation, and definitely stated that rings are absent from the peripheral blood at this period of fever.

At the Nagpur Malaria Conference I combat- ted Major Buchanan’s views, as I had always been able to observe rings at the period of secondary fever. I said [| was of opinion that either Major Buchanan had overlooked rings in his eagerness to count the proportion of flagel- lating and non-flagellating gametocytes, or else had met with some exceptional cases in which the rings were few.

I also pointed out that Major Buchanan’s observations had heen made on living speci- mens which, up to and during the counting process, must have been outside the human body an appreciable period during which flagellation had time to take place. I pointed out that in specimens dried, and so killed immediately on drawing the blood, showed no flagella, and in my experience, always showed rings during the febrile period, provided quinine were not admin- istered,

On my return I observed a number of cases which fully confirmed my opinion, and wrote out the cases for Major Buchanan’s benefit, also sending my remarks as a criticism of his paper on “Flagellar Fever” read at the Conference. He replied he bad modified his views and would not publish his original paper in the Transac- tions of the Conference, whereupon I allowed my criticism also to be withdrawn.

I find, however, he maintains his original theory of intravascular flagellation in the new edition of his book on Malaria, and holds that cases where rings are found during the secon- dary fever are the exception, and that absence of rings is the rule.

I therefore accept this opportunity afforded me by the Chairman's question to say that I have since observed fourteen cases,—giving no quinine, —and that in all fourteen rings were present in abundance during the secondary fever, and in none were flagella seen in films fixed at once.

IT have also corroborated these observations in many cases where, in spite of the adminis- tration of quinine, fever has returned at tke end of the second week.

There is no doubt, however, that about the end of the second week seems to be the rutting season or spring of the young crescent’s fancy, as flagellation is then seen to take place most rapidly after withdrawing the blood. At an earlier period the crescent is immature and unable or slow to flagellate.

THE subject has always been commented upon by sanitarians. It is just now engaging the attention of the highest administrative author- ity. The general public, however, does not seem to be much concerned about it. They are in- different, nay, in some countries at least, the matter is looked upon with favour. Every year an enormous number of the new-born is swept away, not by any pestilence breaking suddenly upon them, but by the slow process of a number of diseases which are ever present in the land. High infant mortality has been noticed in every country and clime, but perhaps nowhere it reaches the figure it does in this country. Infant mortality is subservient to an universal law of nature. It is enormous among the lower animals. The higher it goes, the lower the animal stands in the scale of life. It is one of nature’s safeguards to keep down the population. It is not diseases only but the animals them- selves, even the very parents, which assist nature in her work. The parent cat feeds upon its kittens, the dog upon its pups, the fish upon its eggs. As it is with lower animals so it is with the human being. It is not the savages and semi-civilized people only but the-highly-civilized