"The cases of malaria in the spring and early summer are of the milder, more regularly intermittent varieties (tertian and quartan fever), the severe æestivo-autumnal infections beginning to appear only in the later summer, and reaching their maximum in September."
Manson has recently suggested that the mosquito is an intermediate host for the malarial plasmodium. We have an analogy for this in the part played by the mosquito in withdrawing embryo filariæ (Filaria sanguinis hominis) from the blood of infected individuals and returning them to the stagnant pools frequented by the insect. Manson says, in discussing this hypothesis in his Gulstonian Lectures (1896):
"We can readily understand how the mosquito-bred Plasmodium may be swallowed by a man in water, as so many disease germs are, and we can readily understand how it may be inhaled in dust. Mosquito-haunted pools dry up. The plasmodia in the larvæ and those that have been scattered about in the water, finding themselves stranded by the drought, and so placed in a condition unfavorable for development, pass into a resting stage, just as they do when by quinine or other means man is rendered temporarily unsuited for their active life. They may, probably do, become encysted, as so many of the protozoa do in similar circumstances. The dried sediment of the pool, blown about by winds and currents of air, is inhaled by man, and so the plasmodium may find its way back again to the host from whom its ancestors had, perhaps, started generations back."
This theory appears plausible, but we find it difficult to believe that man is essential for the completion of the life cycle of the plasmodium, for the most concentrated and deadly malarial emanations may be given off from marshy places which are far removed from the haunts of men. It may be, however, that the mosquito is an essential factor in the development of the plasmodium, and that man, instead of being a necessary intermediate host, only serves occasionally, and in a certain sense accidentally, as such. Perhaps other mammals or birds may serve the same purpose. It has frequently occurred to the writer that the malarial plasmodium, like other amœboid protozoa, may find its normal habitat, external to the bodies of its insect or animal hosts, upon the stems and leaves of water plants, rather than in the water itself. The fact that malarial fevers do not prevail in the vicinity of swamps when the marsh vegetation is submerged by high water is in favor of this view; as is also its apparent need of plenty of oxygen, which we infer from its active multiplication in the blood and its parasitic invasion of the red blood-corpuscles.
Possibly the mosquito is an intermediate host for the Plasmodium malariœ on a larger scale than Manson suggests. The
