102 DISEASES DUE TO PROTOZOA 



cerebral abscess, chronic diarrhoea, &c., when the malarial parasite is 

 found, and the condition clears up on the administration of quinine. 



Congenital inalaria is doubted, but one case is on record where a 

 malarial mother gave birth to a child, in the umbilical cord of which 

 parasites were found. After death they were also found in the heart 

 blood. The parasites were identical with those in the maternal blood 

 and the placenta. Bignami and others have failed to find parasites in 

 similar cases. 



Juvenile malaria, when chronic, causes stunted growth and retarded 

 puberty. 



SEQUELiE AND COMPLICATIONS. 



The sequels, such as neuritis, neuralgia, anaemia, cirrhosis of the 

 liver and of the spleen, with traumatic rupture of the same, have 

 already been mentioned, but to these may be added mental modi- 

 fication, insanity, tinnitus aurium, vertigo, deafness, anosmia and loss 

 of taste. 



Malaria may be complicated by — 



Typhoid fever, to which condition the term of typho-malaria has 

 been applied. There is no hybrid or distinct disease, but the one 

 complicating the other, there being two distinct causative organisms 

 present. 



Amoebic dysentery may be present, but one must not forget that 

 malaria itself can cause dysentery. 



Lobar pneumonia is not uncornmon. The low form in chronic 

 malaria is of a deadly type. The possibility of a malarial pneumonia 

 has not yet been decided. 



Nephritis may be present and is due to irritation by the malarial 

 toxins. It is common in children (Daniels). 



DIAGNOSIS. 



Decide positively and treat accordingly if : — 



(i) The fever has a typical quartan or tertian periodicity. 



(2) When malarial parasites are found in the blood. 



(3) When hasmozoin is found in mononuclear leucocytes. 

 Spleen puncture for diagnosis is not devoid of risk. 



A quartan or benign tertian will yield to quinine within four days, 

 but not necessarily so a subtertian attack. 



One must differentiate malaria from : — 



Typhoid Fever, Insolation, Liver Abscess, Kala-azar, Undulant 

 Fever, Influenza, Yellow Fever, Dengue, and Seven-day Fever. 



A mononuclear increase in a differential blood count is useful, but 

 it may indicate a past malarial attack or pneumonia, sepsis, or an acute 



