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Chapter IV 



THE SUBSIDIARY SIGNS OF MALARIA 



When patients have taken quinine it is not 

 uncommonly impossible to find parasites in the 

 peripheral blood. Apart from the actual presence 

 of the parasites, one may still derive evidence of 

 malarial infection from 



T. The presence of pigmented leucocytes. 



2. An alteration in- the proportion of the 

 leucocytes. 



Pigmented Leucocytes. — Pigmented leucocytes, 

 even in severe malaria, are often very few, and 

 often require for their detection prolonged search 

 in large films. In other cases, however, they are 

 abundant. The presence of very few is quite 

 compatible with a severe malarial infection. 

 For instance, in two cases seen by us only very 

 few were found in the peripheral blood, but in the 

 spleen, post-mortem, enormous numbers occurred. 

 To detect them, it is necessary to make large and 

 good films by the method already described. By 

 following the margins and termination of the 

 film, the majority of leucocytes in the film will 

 have passed beneath the eye, and pigment, if 

 present, is readily seen. 



In the vast majority of cases, the pigment 

 will be found in the large mononuclear forms, and 



