CHAPTER XIX 



MALARIA 



Plasmodium Malaria (Laveran); Plasmodium Vivax (Geassi 

 AND Feletti) ; Plasmodium Falciparum (Welch) 



Malaria, or paludism, has been known since the days of ancient 

 medicine, and has always been regarded as the typical miasmatic 

 disease. Its name, mala aria, means "bad air," and is Italian de- 

 rived from the Latin, malus and aer, coming from the Greek diyp, air, 

 from oiEtv, to blow. The other name, paludism, from the Latin 

 palus, a "marsh," refers the disease to the bad air coming from 

 marshes. 



It is a disease of extremely wide geographic distribution, and since 

 the supposed requirement, marshy ground, is found in nearly all 

 countries, and the disease is particularly prevalent in the marshy 

 districts of those countries in which it occurs, the connection between 

 the marshes and the disease seemed clear. Indeed, the two are inti- 

 mately connected, but not in the original sense as will be shown below. 



Both hemispheres, all of the continents, and most of the islands of 

 the sea suffer more or less from malaria, and in many places, 

 especially in the tropics, it is so pestilential as to make the country 

 uninhabitable. Probably no better idea of the wide distribution 

 and severity of the disease can be obtained than by reference 

 to Davidson's " Geographical Pathology."* 



The disease assumes the form of a fever of intermittent or remittent 

 type, characterized by certain peculiar paroxysms. When typical, 

 as in well-marked intermittent fever, these are ushered in by de- 

 pression, headache, and chilly sensations, which are soon followed by 

 pronounced rigors in which the patient shivers violently, his teeth 

 chattering. The temperature soon begins to rise and attains a height 

 of 102°, 104°, or even io6°F., according to the severity of the case. 

 As the temperature rises the sense of chilliness disappears and gives 

 place to burning sensations. The skin is flushed, hot, and dry. 

 After a period varying in length the skin begins to break out into 

 perspiration, which is soon profuse, the fever and headache disappear 

 and the patient commonly sinks into a refreshing sleep. The 

 frequency of the paroxysms varies with the type of the disease, which, 

 in its turn, can be referred to the kind of infection by which it is 

 caused. The paroxysms exhaust the patient and incapacitate him 

 and may eventually prove fatal, though in by far the greater number 

 of cases the disease gradually expends itself and a partial or complete 

 recovery ensues. Some cases, known as pernicious, are rapidly fatal, 

 * D. Appleton & Co., New York, 1892. 

 471 



