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Case 13.- -An Indian Policeman admitted for fever. Parasites were found in his blood but in spite of quinine the temperature ran a typhoid course till the 11th day when some characteristic sputum was obtained in which were numbers of plague bacilli though there were no lung symptoms of any note. He was transferred to Kennedy Town Hospital, recovered and returned to us for debility. After two days' stay he had another bad attack of malaria with parasites in his blood. He is now well and doing his duty.

Case 14.--Admitted with fever and numerous parasites in the blood. He looked ill but had no bubo and no plague bacilli could be found. He died suddenly from heart failure and at the post mortem there was found an extensive retro-peritoneal hemorrage with both malaria and plague bacilli in the spleen.

Case 15.--A Chinese Policeman was admitted and malaria found in the blood. In spite of quinine the temperature still continued without any symptoms save a clean but tremulous tongue and no plague bacilli could be found. On the 10th day a cervical bubo developed and he was transferred to Kennedy Town Hospital. These and other cases we might mention show how difficult it is to diagnose some of these non-bubonic cases when combined with malaria.

RHEUMATISM.

Nine cases were examined, 6 being positive and 3 negative, one of the latter, if not two, being due to gonorrhoea. Acute rheumatism is said to be rare in this Colony and our experience bears out this view, but there is a great deal of what, for want of a better name, is called "rheumatism.' Patients who have no swelling in the joints and little or no fever come to hospital complaining of nothing but pains in or about the joints. It is, in these cases, extremely difficult to be sure one is not being imposed upon, as "pains all over" is a favourite way of getting a few days' rest, but we cannot help thinking that if more of these cases were examined it might turn out that some of them were really a form of malaria. If this disease produces inflammation of the nerves and their sheath one does not see why it should not equally affect the fibrous ending of muscles or joint ligaments without giving rise to any objective signs much in the same manner as syphilis does. For obvious reasons, not many of these cases are admitted to hospital so we have not been able to collect more cases. One case is, we think, worth recording.

Case 16. -European Constable admitted several times to hospital with malaria (fever and sciatica) came in again in April with fever. Parasites were found as usual and he had effusion and pain in the right elbow and left knee. Under salicylate of quinine and blisters he improved slowly when sud- denly the right knee became full of fluid, but without any pain. He eventually recovered after six weeks' stay but returned again with malaria and sciatica and was invalided home, having been in hospital for malaria every month in the year.

JAUNDICE.

This is by no means a common sequelae of malaria though hepatitis is common enough. Four cases were examined and 3 showed malaria. The fatal case is worth recording.

Case 17.-European sailor from a coasting steamer was admitted to hospital with fever. His conjunctivæ were slightly jaundiced, temperature 100°, pain over left lobe of liver and vomiting. The blood slide teemed with malaria of the malignant type. The temperature rose to 104° and the jaundice extended more rapidly than we have ever seen before. Notwithstanding hypodermics of quinine and other treatment delirium set in and he died three days after admission. The post mortem showed no obvious cause for the jaundice though the gall bladder was distended. A smear from the spleen teemed with malaria.

HEPATIC COLIC.

One case was under treatment and his blood showed mixed malarial infection. Under quinine and morphia he recovered without jaundice.

BERI-BERI.

We do not see very much of this disease owing to our limited accomodation. Five cases were examined and three showed malaria.

Case 18.-Bad attack of malaria and acute beri-beri. Notwithstanding iron and arsenic and 15 grains of quinine every morning for 10 days he had a second attack of malaria and yet a third 18 days after. He was a long time in hospital but eventually recovered completely. If more cases were examined we have no doubt malaria would be frequently found associated with this disease.