A Study of Induced Malignant Tertian Malaria *James, S. P., Nicol, W. D., and Shute, P. G. (1932). A study of induced malignant tertian malaria. Proc. Roy. Soc. Med., XXV, No. 8, June, 1932. Sect. Trop. Dis. and Parasit., p. 1153.

Workers in Great Britain on induced malaria therapy in mental patients have the advantage of working with 1 clean' material under fully controlled conditions, and of being able to select recipients who have never previously been exposed to infection with malaria. The consequence is that their results are often surprising to workers in the tropics who are far more often dealing with relapsing or recrudescent malaria. This very important memoir by Colonel James and his colleagues forms no exception to this rule. It constitutes a notable contribution to malariology and should be read in the original by all malaria workers in the tropics. The authors commence by claiming that in such a well run hospital as Horton it is justifiable to treat mental cases by infections with P. falciparum, especially the type of case which has failed to benefit by benign tertian or quartan infections. There were three fatalities among the first 22 cases treated (one being due to advanced carcinoma), but none among a subsequent series of over 50 cases treated. The mortality from induced malignant tertian malaria worked out at only 4 per cent, as compared with a figure of 10 to 14 per cent, for patients treated with benign tertian malaria in mental hospitals in England and Wales. The paper deals with 54 patients so treated, 31 infected by direct blood inoculation, and 23 by mosquito bites; 33 of them having received a previous course of malaria therapy and 21 of them having had no malaria previously. (The 33 patients who had previously received a course of malaria therapy were presumably then inoculated with P. vivax, but in their figures for relapses the authors do not seem to recognize that this