86 DISEASES DUE TO PROTOZOA 



Phagocytosis is carried on more by the large mononuclear elements 

 and transitional leucocytes than by the polys. A phagocyte may 

 engulf a red cell and its contained parasite. 



Vacuolization and a reduced staining power have been noticed. 



Myelocytes have sometimes been found in subtertian cases (Da' 

 Costa). 



MORBID ANATOMY. 



(i) In acute vialaria of P. malarice. 



The parasite does not especially accumulate in any one organ. 



The spleen is enlarged, not soft or very melanotic. 



The liver and bone-marrow may be markedly melanotic. 



There are parasites in the spleen and the blood, but not in the brain. 



(2) In acute malaria of P. vivax. 



Death may be caused in rare cases by coma, hsemoglobinuria with 

 pigmentation of the bone-marrow, spleen and liver. The spleen is 

 enlarged. Its contained blood shows large numbers of parasites. 



The kidneys and colon are inflamed. 



The endothelial cells of the brain are swollen and contain pigment 

 (Ewing). 



(3) In the acute malaria of L. malarice. 



The organ chosen for sporulation suffers most, and produces the 

 symptoms giving the character of that particular type of the disease. 

 The organ attacked principally may be the brain, intestine, heart or 

 pancreas. 



Macroscopic. 



The body is pale, yellowish in white races; the heart muscle pale 

 and flabby; ecchymoses sometimes in the epi- and endo-cardium. 



The lungs may be normal or congested, rarely sclerosed. 



The liver is enlarged, dark brown to slate colour on section, soft 

 and congested. 



The gall-bladder is full of dark bile. 

 The spleen is enlarged, capsule tense; on section, deep brown to 

 black in colour. 



The stomach and intestines are not affected, except in choleraic 

 forms, when the mucous membrane is congested (except about Peyer's 

 patches and the solitary glands) with blood-stained contents, flakes of 

 mucous and dark pigmentation due to h^mozoin readilv demonstrated 

 by the microscope. 



The lymphatic glands are swollen. 



The pancreas is normal or in a condition of hcemorrhagic pan- 

 creatitis. 



The suprarenals are congested. 



The kidneys are normal or congested, with punctiform haemorrhages 

 in the pelvis, and cloudy swelling in the parenchyma. 



