MALARIA 99 



facial paralysis or paresis, increased tendon reflexes, ataxia 

 and vomiting. 

 (y) Cerebellar. — There is cerebellar ataxia, severe headache, 

 vomiting, &c. 

 (6) Gastrointeslinal P.S.F. 



The symptoms may resemble — 



(a) Cholera. — There is vomiting, abdominal pain, severe 

 diarrhoea, the stools are loose, profuse and numerous, pain- 

 ful cramps of legs. 

 Collapse may ensue with sunken eyes, cyanosis, clammy 

 skin, hiccough, severe thirst, scanty urine, delirium, coma 

 and death. 

 Occasionally a case recovers. 

 The condition may be mistaken easily for true cholera, but 



the stools usually contain some bile (not rice water-like). 

 The blood also will show indications of malaria. 

 This manifestation is seen in the Punjab. 





=5e 



Parasites in capillary from intestine. 



(6) Dysentery. — The fever is usually high. 



The stools contain blood and mucus tinged with bile. 

 There is great distress and prostration. 

 The pulse is small and rapid- 

 Quinine may result in rapid recovery. 

 (c) HcEmorrhagic Pancreatitis. 



The diagnosis is made after death. 

 It is seen in Ceylon. 



There is an acute onset with epigastric pain. 

 There may be signs of partial intestinal obstruction with 

 marked collapse. 

 ((/) Peritonitis. — This may be simulated when the suprarenal 

 glands are affected in particular. 

 (7) Cardiac P.S.F. 



The right heart is enlarged, there is severe cardiac pain, and 

 vomiting of blood. 



