CORRESPONDENCE MEDCAL JOURNAL 351 means exceptional in the Congo and in W. Africa, where it was formerly thought to be rare. P. vivax seldom, if ever, produces alarming symptoms or causes death. From the military point of view its importance lies in its nuisance value, apparent resistance in wartime to textbook treatment, and its great liability to relapse again and again. In thcose primary infections which are now occurring in soldiers returning from the Mediterranean the latent period may be

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... rolonged to three months, or even as long as one year, till the malaria declares itself. The degree of anaemia produced is slight, but the splenic enlargement is usually more marked than in the subtertian, while the general health between relapses is good. In civil life relapses are regarded merely as a temporary inconvenience and hardly any justification for prolonged stay in hospital. Benign tertian certainly possesses a tendency to seasonial recuirrence, and European infections are liable to relapse in spring, early summer, and autumn. This parasite is particularly persistent, and may survive in the body and produce relapses (outside the endemic area) for two to three years. Cerebral and other severe syndromes are unknown, and althouglh the parasites disappear from the peripheral blood with quinine treatment, this drug does not entirely extirpate them, so that in heavily infected individuals these disappointing relapses are apt to occur. I have for more than ten years thought and taught that mepacline (atebrin) possesses little of the virtue in the treatment of benign tertian which it undoubtedly has in subtertian. As the treatment of malaria is again, as under similar circumstances a quarter of a century ago, being severely criticized, what, tlhen, is the best course to pursue? We can dismiss suiotertian