JAMA. 1909;LIII(26):2150-2153. doi:10.1001/jama.1909.92550260001001d.
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The pernicious types of malaria are of absorbing interest because of their diverse clinical features and their high mortality. Complex problems are attractive, and a high death-rate in any disease is apt to stimulate the energies even of the slothful.

Pernicious malaria presents such problems, and their solution deserves the study of our best clinicians, for much more work is required to be done in their fuller elucidation. The term "pernicious malaria," while conveying an impression more or less definite, to the rank and file of the profession, and, therefore, to that extent serving a useful purpose, has none the less impressed me as being indefinite.

Perniciousness is a quality that may characterize any disease, and is doubtless dependent on a number of conditions. One might just as well speak of pernicious scarlet fever, pernicious measles, pernicious smallpox. Instead, however, we speak of malignant scarlatina, black measles, hemorrhagic smallpox.


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