Two monographs on malaria and the parasites of malarial fevers : I. Marchiafava and Bignami. II. Mannaberg.

Date:
1894
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Licence: Public Domain Mark

Credit: Two monographs on malaria and the parasites of malarial fevers : I. Marchiafava and Bignami. II. Mannaberg. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    was three to five hours before the attack. The next attack, indeed, follows with full severity, but the following attacks do not occur, often indeed without the further administration of quinine. Golgi has observed that parasites preparing for seg- mentation were not influenced by quinine, but that they completed that process notwithstanding the drug; on the other hand, he found that the young spores were exceedingly suscep- tible to quinine. Now, if at the time mentioned (three to five hours before the attack) i gramme (15 grains) of quinine is administered, then the blood at the time of the attack will contain so much dissolved quinine that the spores just formed, the whole young brood so to say, are killed in statu nascendi and thereby the attack which should follow is rendered impossible. It has been long known and has been recently confirmed by Golgi that when quinine is administered about six or eight hours before an attack it will be postponed and weakened ; in this way a postponing type can be artificially produced. In multiple infections with quartan parasites Golgi succeeded sometimes in killing one generation after another, and thereby changing a triple quartan (quotidian) first into a double and finally into a single quartan. This experiment can be performed if a small dose of quinine, about 0*4 gramme (6 grains), is given two hours before the attack; with this small dose one succeeds in killing a large part of, or under certain circumstances all, the spores newly formed during the attack, so that one generation is removed. The large forms of another generation which may be present are not at all or only slightly injured by the small dose of quinine ; they remain uninfluenced and produce the corresponding fever type. This experiment does not invariably succeed, because the differences in susceptibility of the various stages of the parasite are by no means very great, so that small doses may cause damage to all the generations and thereby prevent the gradual production of the attacks. By the administration of quinine, not at the favorable period of the spore-formation, but at an haphazard period, the type of fever is often delayed. The par- oxysms which formerly occurred at regular intervals can be either separated further from one another or drawn nearer together, according to whether the therapeutic measures have curbed one or other generation of parasites in its development or left it intact. Similar observations to those which Golgi has made with regard to tertian and quartan fevers have been made by Marchia- fava and Bignami [100] with malignant tertian fever. They
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