276 THE AMERICAN MONTHLY [Sept 



ship for reporting, as malaria, cases whose blood prepara- 

 tions afterward proved to contain only blood plates and 

 no Plasmodia. Coagulation products have been confused 

 with flagella. Many of the small dots seen in malaria 

 which resemble micrococci and were mistaken for such 

 by the earlier Italian observers are similar to those 

 found in most anemias and described by Ehrlich as 

 degenerative changes. 



Technique. — Complex methods of staining and count- 

 erstaining the parasite have been in vogue, but the sim- 

 plest and most accurate is the direct examination of the 

 freshly-drawn unstained blood, a method we have used 

 with entire satisfaction for several years. In this pro- 

 cedure injury to the corpuscles and staining of the blood 

 plaques are obviated. 



The lobe of the ear is cleansed, picked, and a quite small 

 drop is gently expressed. A clean cover glass is held in 

 a pair of forceps to avoid the heat and moisture of the 

 hand, and is carefully brought in contact with the top of 

 the drop. The heat and moisture of the hand or rudely 

 placing the cover against the drop favor imperfect spread- 

 ing from precipitate drying of parts of the blood. Rub- 

 bing the slide well facilitates equable spreading of the 

 blood. Examination is best made with an oil one-twelfth 

 inch immersion lens, although Laveran used lenses of 

 lower magnification. Permanent preparations are pro- 

 cured by allowing the covers to dry, to remain half hour 

 in equal parts of absolute alcohol and ether and by paint- 

 ing with filtered eosin and methylene blue. The use of 

 stains is not usually advisable, since they obscure the 

 otherwise more brilliant microscopical findings, they act 

 as protoplasmic poisons, abolishing both the amoeboid 

 movement of the parasite and the highly characteristic 

 vibrations of its pigment, and finally, they stain the 

 blood plates and coagulation produces, thereby confu- 

 sing the findings, particularly for the unwary clinician. 



