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most common, but four, eight, and sixteen-forms are 

 frequently seen, especially at the crisis. 



Free forms are derived from the intracorpuscular 

 forms, and are usually arranged in groups of four, 

 eight, or sixteen forms. After leaving the cell para- 

 sites stain more deeply and sometimes appear slightly 

 larger. In fresh films they exhibit more or less rapid 

 movements and a vibratile action of the fine end. 

 A flagellum-like process is sometimes present in this 

 position, but can rarely be made out in stained films. 

 The chromatin of a parasite consists of (i) A dense 

 mass, the nucleus proper, which is always present ; 

 (2) A ragged lighter staining extension of this, which 

 can generally be made out in all well-stained specimens; 

 and (3) A minute punctiform mass, not always present, 

 the so-called blepharoplast. 



Changes in the blood are profound, and consist 

 of (i) Reduction in red cells to 2,000,000 or less ; 



(2) Reduction in haemoglobin to a less extent ; 



(3) Leucocytosis, the number of cells reaching 50,000 or 

 more as against the normal number of 7,000 to 8,000 ; 



(4) Appearances of nucleated red cells and rapid 

 formation of new corpuscles. 



Post-mortem. Parasites may be more numerous 

 in the organs than in the peripheral blood, but are not 

 always so. Thus while the number of corpuscles in the 

 peripheral blood may be one to three per cent., in the 

 capillaries of the heart there may be seventy per cent. ; 

 in the lung, fifty per cent ; kidneys, forty per cent ; 

 brain, eighty per cent. ; spleen (trabecular veins), fifty 

 per cent. The parasites are mostly small and spherical. 

 The changes in the organs are most marked in the 

 chronic cases. Ecehymoses occur in various organs, and 

 according to Nocard all changes are due to great 

 dilation of the capillaries by blood cells full of parasites. 



