Notes on the etiology of relapse in malarial infections / W.M. James.

  • James, W. M.
Date:
1913
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Licence: Public Domain Mark

Credit: Notes on the etiology of relapse in malarial infections / W.M. James. Source: Wellcome Collection.

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    ~ upon as an indication of successful exhibition of the drug, is unre- liable as a test of toxicity against the parasites, for cinchonism is more indicative of the patient’s susceptibility to quinine than it is that the remedy is doing the work for which it was given. The fact that of all systems of medication the intravenous method in high dilution, as first recommended by MacGilchrist,* is the most successful in freeing the circulation of the spleen and matrow of parasites, suggests that even in the process of absorption after hypodermic injections some of the effects of the drug are lost. SUMMARY. | If the hypothesis be accepted that the asexual cycle alone is the cause of relapse, and under certain conditions takes on a rela- tive immunity against quinine, an explanation is offered of all the factors concerned in the etiology of relapse, and I know of no other hypothesis which will explain satisfactorily the correlation between these factors and the data which to this time have been collected about relapse. I may summarize these factors, which were given early in this paper, in relation to the asexual cycle as follows: t. Relapse is one of the most common factors in malarial infection; and certainly the asexual cycle is that phase of the malarial parasites found most frequently associated with the primary infection and relapse, and with one relapse and the suc- ceeding one. 2. Relapse follows frequently the so-called spontaneous cure of malaria, because the asexual cycle in such an instance often persists, in numbers that can be detected by the “thick film”’ method, or slightly below this limit, in the intervals of apyrexia. . 3. Infections treated insufficiently with small doses of quinine will in all probability relapse, because the parasites of the asexual cycle in the spleen and marrow are very slightly, if at all, affected thereby. 4. Relapse is less likely to occur when the infection is promptly and vigorously treated, because the older the asexual cycle, the more resistant to quinine it becomes, as shown by numerous clinical observations. t Quinine and Its Salis, Cited in Paludism, Simla, to11.
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