Use of quantitative parasite inoculation doses in Plasmodium vivax malaria therapy.

CUMULATIVE experience with therapeutic malaria in the management of neurosyphilis during the past twenty-five years has resulted in refinement of technics and in a clearer understanding of the characteristics of induced malarial infection. The febrile course of Plasmodium vivax malaria, following either natural or artificial inoculation, in most instances does not display the regular tertian paroxysms commonly described in textbooks. The majority of infections exhibit quotidian cycles with varying degrees of irregularity. At the onset of clinical activity, following mosquito inoculation or the usual administration of a 5 to 10 cc. inoculum of blood at institutions utilizing therapeutic malaria, a period of several days of remittent fever, characterized by continuous low grade elevations of temperature, to 101 or 103 F., is experienced. This period of remittent fever is commonly accompanied with severe malaise and exhaustion, often debilitating the patient prior to the establishment of true malarial paroxysms.