In this table, for the purpose of comparison, I have used the figures for two complete years only.
There were from— -
January to June, 22 quartan, 388 tertian, 380 summer-autumn.
July to December, 10 quartan. 776 tertian, 639 summer-autumn.
This table shows a most striking contrast to the Italian and Algerian figures, which had apparently justified the giving of the name of " Summer-Autumn " to the malignant parasite and the fever it causes.
In the Johns Hopkins Hospital in the United States there were in the months—-
January to June, 1 quartan, 112 tertian, 8 malignant.
July to December, 4 quartan 1226 tertian, 191 malignant.
The majority of the malignant cases occur- ring in September and October.
Buchanan gives figures for ten months in the Central Provinces : —
 | A table should appear at this position in the text. See Help:Table for formatting instructions. |
The Bombay tables show that in the first six months of the year there were 790 cases; in the second six months 1,425; and that benign and malignant cases increase at much the same seasons. Malignant cases were in the majority in January, February, April, June and December. "Spring" tertians were in the majority in March, May, July, August, September, October and November.
The term "Summer-Autumn Fever " is bherefore singularly inappropriate in Bombay.
In the annual reports of our Indian hospitals we have two columns of statistics, "Intermittent" and " Remittent" fever, to fill up. I am in the habit of entering all cases of benign quartan and tertian infection under the former heading, and all " Summer-Autumn " infections under the beading " Remittent."
I am not anxious to justify this procedure, but I may say all benign cases have shown a distinctly intermittent character. The "Summer- Autumn " Ijaverania prcecox has often produced a remittent type of fever as well as a distinctly intermittent. As there has not been a death among 1,186 consecutive cases of infection, the name ** malignant" has scarcely been earned.
The rarity of quartan fever is noticeable in my tables, and would have been still more
striking, but for the fact that there was a curious run of these cases in the last week of April and first fortnight of May this year. In those three weeks I met eleven cases, only five of which were recognisable clinically.
In the United States of America quartan is also rare. In the Johns Hopkins Hospital in seven years there were only 15 quartan infections among 1,618 cases of malaria, a little less than the proportion in Bombay — 41 quartan in 2,542 infections.
. Crombie says quartan is so rare that he only met one case in all his twenty-two years' service in India. This estimate is too low, and as many of my clients in Assam passed through his hands, I venture to think Colonel Crombie's statement is based on clinical observation rather than on examination of the parasites, and that he must have overlooked some double and treble infections.
| A table should appear at this position in the text. See Help:Table for formatting instructions. |
