98 DISEASES DUE TO PROTOZOA 



There may be improvement for tAventy-four hours with 

 relapse and death. Some cases recover. 



(b) Hyperpyrexia. — The temperature may rise to 107° — 108° F. 

 There may be brief mania, followed by muttering delirium, 



unconsciousness, coma and death in one or a few hours. 

 It is due to embolism by malarial parasites, swollen cells, 

 debris, &c., blocking the capillaries supplying the thermic 

 centre. 



(c) Delirium. — There may be delirium with sudden onset, 



followed by exhaustion, coma and death. All are fatal. 

 The fever is usually high. It may be mistaken for thermic 

 fever. 



(d) Tetanus. — Some delirious patients may show trismus, con- 



traction of limbs, opisthotonos, retraction of abdomen, and 

 conjugate deviation of the eyes. 

 There may be recovery or death with hyperpyrexia. 



(e) Eclampsia. — Children may have convulsions, stupor, coma 



and death. 



(/) Meningitis. — It occurs in young persons and children. There 

 are : vomiting, slow pulse, headache, retraction of head, 

 rigidity of neck, convulsions, hyperc'esthesia, fever, 

 irregular pulse, coma and death. 



(g) Hemiplegia. — There may be all ihe signs and svmptoms of 

 hemiplegia with paralyses. There may be aphasia, often 

 resulting in permanent psychical disturbances, loss of 

 memory, &c. This is due to the blocking of the capillaries 

 supplying Broca's convolution (embolism). 



(h) Amblyopia. — Blindness is sometimes complained of, is 

 usually only temporary lasting for several davs, but in 

 some cases it persists, when there may be found optic 

 neuritis, peripapillary oedema, extravasation of leucocytes, 

 plugging of retinal or choroidal vessels bv parasites, pig- 

 ment, leucocytes and consequent multiple haemorrhages in 

 the fundus (Poncet). 

 In quinine amblyopia (see p. 524) there is retinal anccmia 

 due to toxic spasm of the arterioles and the amblyopia is 

 more persistent. The discs are white and the vessels 

 shrunken, while no inflammator}^ symptoms are present. 

 In the malarial condition one eye only mav be affected, and 

 the condition may clear up quickly under quinine treat- 

 ment. The pupils react to light, but they do not react in 

 quinine amblyopia. 



(i) Bulbar. — There is difficulty of speech and deglutition with 



