MALARIA loi 



CHRONIC MALARIA. 



The causative organism is usually Laverania malari^e, but either 

 of the malarial parasites may cause it. 



The numerous symptoms are often slight but frequent. There 

 are : — 



Repeated small fevers, enlargement of spleen and liver, pigmenta- 

 tion of skin and mucosae, oedema of feet, anaemia which is often 

 marked, haemorrhages which make operations dangerous, multiple 

 neuritis, skin eruptions, sinovitis, palpitation, dizziness, bronchial and 

 intestinal disturbances, morning diarrhoea, fleeting pneumonias and 

 headaches. 



Sometimes the fevers are absent, such not being necessary for the 

 condition. 



The spleen may become enormous in size, firm but painless. It is 

 very friable, and may be ruptured by slight blows or even spon- 

 taneously. 



Vigorous games and corporal punishment should be withheld from 

 such. 



The liver enlarges from chronic hepatitis. There is hypertrophy 

 of the intralobular connective tissue which leads to hypertrophic or 

 atrophic cirrhosis. This incurable condition leads to portal obstruction 

 and ascites. The h^emosiderin may be in blocks as large as blood 

 corpuscles. The term " Siderosis " is then applied to this condition. 



The secondary anaemia may be profound with loss of red cells, and 

 Hb., with a large increase of the mononuclear elements. 



Abortion and sterility are common effects of this anaemia. 



The condition described above is known as " Malarial cachexia.** 



If the acute conditions were adequately treated with quinine this 

 condition could hardly arise. 



Unfortunately malarial relapses are exceedingly common even when 

 quinine has been administered and without reinfection. Some of the 

 parasites, lying dormant, wake up later and cause a relapse for some 

 unknown reason, unless it is because the resistance of the patient is 

 diminished at that time. 



Recurrences may often occur after several years. Malarial parasites 

 have been found in the blood four years after leaving a malarious 

 district. Apparent recurrences in malarial districts are usually re- 

 infections. 



Latent malaria is a term given to a condition when malarial 

 parasites are found in the blood and there are no symptoms present. 



The parasite is usually of the subtertian variety. 



Masked malaria is a term used when there may be neuralgias, 



