EBVIEW TROPICAL MEDICINE, ETC. Ill 



Thiroux,' on the other hand, supports Laveran's view as to the unity of the malaria Malaria- 

 parasite. Ho examined native cliildren in Senegal and found that in the hot weather the continmd 

 tropical forms amounted to 9-5 per cent., and large forms (benign tertian and quartan) 

 to 1-5 per cent., while in November and December the respective figures were 73-5 and 

 26-4 per cent., and in March and April they were 64-1 and 35-8 per cent. He considers it 

 difficult to admit the existence of a summer and winter malaria due to absolutely different 

 species. 



It appears to me that some work on these lines could be carried out with advantage in 

 the Southern Sudan, and possibly one may be able to arrange for this in the next programme 

 drawn up for whoever may have charge of our Floating Laboratory. 



Cropper- exhibited very interesting blood-films from a fatal case of pernicious 

 malaria which contained a phenomenal abundance of parasites in the peripheral circulation. 

 His description of the slides shown may be quoted : — 



1 and 2. Clumping of infected red cells, each containing a pigmented praesegmenting body, suggesting a 

 cause for the embolism or infarction of the different organs affected in pernicious attacks. 



3. Very numerous unpigmented rings ; of 500 corpuscles counted at random from 40 to 50 per cent, were 

 infected, and in some fields more, so that in one field 100 parasites can be seen. Up to this time twenty parasites 

 in a well-spread field was the most I had seen. 



4 and 5. A red cell containing six unpigmented rings, in another slide ; two corpuscles can be seen in one field, 

 each containing five rings. 



6. Subtertian gametes m- crescents in all stages of development. 



Towards the end the number of crescents increased in a marked manner, four, five, or sis were seen in a single 

 field, and suggest to my mind some sort of migration from the bone-marrow on the onset of algide symptoms. 

 I give this for what it is worth. In very few cases are the crescents mature, and they are nearly always straight 

 and fusiform, not crescentic ; the pigment is nearly always discrete. The young male crescents are often i^erfectly 

 circular in outline, and occupy the centre of the cell, being surrounded by a ring of haemoglobin, the female 

 gametes being sharply pointed. They can be distinguished from young segmenting forms by the fact that the 

 pigment in the latter is nearly always gathered into a compact mass, even at an early stage. In any case, the 

 chromatin exists as a distinct band across the Equator. 



7. Two sporuJating bodies in one cell, 



8. Three prmsegmenting farirus in one cell. These, though somewhat rare, tend to show that when double or 

 treble infection occurs, each parasite goes on to full development, and effectually precludes the occurrence of any 

 form of endocorpuscular conjugation, as described by Craig, of the American Army, in the Philippines. 



9. Polymorphonuclear leucocyte containing sporulating body. 



10. Leucocyte containing three sporulating bodies. 



11. Pigmented leucocyte containing twenty-five pigment masses, each indicating one sporulating parasite ; the 

 protoplasm of the cell is very much enlarged. 



A similar account of this case, illustrated by a coloured plate, will be found in the 

 Lancet of July 4th, 1908. 



Cases of sporulating malignant parasites in the peripheral blood are rare. Cropper 

 believes they must be commoner in some countries than in others. The case in question 

 was from Palestine. As a rule, also, immature crescents are not seen in the peripheral 

 circulation. Eosettes and sporulating forms in the white cells are usually seen in the large 

 mononuclears, but Manson mentioned a ease of a complete sporulating form in a 

 polymorphonuclear leucocyte. 



One may mention here the excellent German blood atlas of Meyer and Eieder^ 

 which contains good plates of the three types of malarial parasites and shows forms not 

 usually seen in illustrations. These authors hold that it is possible to distinguish the 

 young gametes in the red blood corpuscles. Special attention is directed to a ring form of 

 gamete which only occurs in pernicious malaria. As regards benign tertian gametes, the 

 young forms are recognised by the absence or relative insignificance of the nutrition 

 vacuole, the older forms by their size, the compactness of their form (the protoplasm 

 almost never showing amoeboid prolongations) and their undivided nuclei. The occurrence 

 of multi-nucleated gametes is rare. 



Eeference may here be made to Cropper's bodies, which are so apt to be mistaken in 

 fresh films for malarial plasmodia. These were first described by Eoss-** in India, then by 



1 Dr. Thiroux (September, 1906), " Des Relations de la Fievre Tropicalc avec la Quarte et la Tierce." Annals 

 de rinstiliU Pasteur, p. 766, Vol. XX. 



= Cropper, J. (March 16th, 1908), " Phenomenal Abundance of Parasites in the Peripheral Circulation of a 

 Fatal Case of Pernicious Malaria." Journal of Tropical Medicine and Hygiene, p. 91. 



^ Meyer, E., and Rieder, H. (1907). Atlas dcr Klinischen Mikroskopie des Blutes. Leipzig. 



■• Boss, R. (February, 1896). Indian Medical Gazette. 



* Article not consulted in the original. 



