SUBTERTIAN MALARIAL FEVER 47 



to this stasis in cardiac capillaries in part, but may occur 

 with quartan malaria, especially in cases of beri-beri, and 

 so may be due to a direct toxic effect on the cardiac nerves. 

 (5) The blood-pressure is usually raised as a result of 

 such stasis, and actual haemorrhages are not infrequent 

 and may occur in any part of the body. Where there 

 is old atheroma in the cerebral vessels, fatal cerebral 

 haemorrhage may occur. 



FIG. 21. Parasites in Capillary from Intestine. 



Complications. Albuminuria in some places is common 

 during a. febrile attack; in other places it is unusual. In 

 children nephritis is a common sequela, but in adults it 

 is rare ; this nephritis is sometimes fatal. In many 

 malarious countries this sequela is not met with. Haemo- 

 globinuria, and its possible relationship to malaria, will 

 be considered under blackwater fever. Glycosuria may 

 occur during the febrile attacks, but is rare. Haemor- 

 rhages may occur from various parts of the body. Epis- 

 taxis is common. Haematemesis, melaena, passage of 

 blood by rectum, though rare, have been seen on many 

 occasions. Haematuria has been recorded, but is very 

 rare. Neuritis, peripheral and multiple, is often described, 

 but in most instances it is more probably due to alcohol, 

 arsenic, and sometimes to beri-beri ; as a rare sequela it 

 does occur, and then rapid improvement takes place with 

 quinine treatment. Still more rarely paraplegia may 



