CHAPTER XIX 



MALARIA 



Plasmodium Malaria (Laveran); Plasmodium Vivax (Grassi 

 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 d^p, 

 air from auv, 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 be- 

 tween the marshes and the disease seemed clear. Indeed, the two 

 are intimately 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, es- 

 pecially 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 remit- 

 tent type, characterized by certain peculiar paroxysms. When 

 typical, as in well-marked intermittent fever, these are ushered in 

 by depression, headache, and chilly sensations, which are soon fol- 

 lowed by pronounced rigors in which the patient shivers violently, 

 his teeth chattering. The temperature soon begins to rise and at- 

 tains a height of 102°, 104°, or even io6°F., according to the severity 

 of the case. As the temperature rises the sense of chilliness disap- 

 pears 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 head- 

 ache 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 in- 

 capacitate 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 per- 

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

 495 



