We do not understand why in one case sporulating parasites should plug the capillaries of the central nervous system, with the production of conditions resembling well-recognized nervous diseases, while in another case the damage is done the intestinal mucosa, pancreas or lungs. At any rate these pernicious manifestations of malaria should always be kept in mind when a case of sudden cerebral involvement or acute abdominal disease shows itself in a patient in a malarious country and a blood examination should be promptly made. _Cerebral Manifestations of Pernicious Malaria._—Various authorities give different clinical pictures but the more commonly accepted types are: (1) The hyperpyrexial, when the symptoms are those of heat stroke, with a temperature going up as high as 110°F. or even higher. Such patients rapidly become comatose and as a rule die. (2) The delirious and comatose forms are apt to be associated, the comatose condition following a delirious state. Such manifestations may or may not set in with a chill. Cases belonging to this group may arise from a typical malignant tertian infection in which the headache and restlessness have been unusually marked. The pulse is full and fast with sighing respiration, hot dry skin and flushed face. There may be rigidity of the neck muscles. (3) Such terms as epileptiform, tetanic, aphasic, cerebellar and bulbar have been applied to malarial manifestations and are self-explanatory. Cerebral malaria may give rise to a delusional insanity. Various psychoses or amnesia at times follow cerebral types of pernicious malaria. _Algid Manifestation of Pernicious Malaria._—In such cases we have a small thread-like pulse and a cold clammy skin. There are signs of collapse. The respiration is slow and shallow and the voice weak. It is customary to consider some of these cases, when there is vomiting and diarrhoea, with painful cramps of the legs and scanty or suppressed urine, as of choleraic type, while other cases, with blood and mucus in the stools and marked abdominal pain are termed dysenteric. Most dysenteric types only show a diarrhoea with the presence of blood. The dysenteric type is more common but the question always arises whether the case may not have been really dysentery lighting up a latent malaria or the lowering of resistance from the malaria favoring a dysenteric infection. Stott had five algid cases of dysenteric type but not one of choleraic. The choleraic types have often been reported during outbreaks of cholera. When epistaxis and haemorrhages from the intestines or stomach are marked features of an attack the cases are termed haemorrhagic and, if a prostrating, collapse-producing sweat be a characteristic feature, they are called diaphoretic. Cases have been observed when the excessive sporulation was apparently taking place in the pancreas, giving the symptomatology of acute haemorrhagic pancreatitis.