BLOOD PARASITES— LEU K/EMI A 



1903 



BLOOD PARASITES. 



The blood may contain a number of parasites — e.g., the malarial 

 parasites, the spirochaetes, the trypanosomes, the kaia-azar 

 parasites — ^as well as certain worms — e.g., the Microfilariae, Schisto- 

 soma hcBmatohium, S. japonicum, and S. mansoni. 



ANEMIA AND ALLIED CONDITIONS. 



AnsBmia is common, being generally associated with ankylo- 

 stomiasis, malaria, kala-azar, chronic dysentery, or in women 

 repeated pregnancies and prolonged lactation. It is especially 

 common among coolies working on estates. The treatment is to 

 remove the causal agent, and then to administer the old mixture of 

 sulphate of iron, sulphate of magnesium, and nux vomica to the 

 poorer classes, while intramuscular injections of iron alone or com- 

 bined with arsenic or sodium glycerophosphate are more scientific 

 and more suitable for the better classes. 



Chlorosis is rare, but we have seen cases in Europeans and in 

 better-class native girls, 



Paransemia Tropicali?. 



Everyone residing in the tropics is acquainted with the pallor 

 which is visible in the faces of many European residents who, 

 apparently, are in good health. An examination of the blood 

 fails to reveal any marked diminution in the red cells or haemoglobin, 

 or, at all eVents, no such reduction as would be compatible with the 

 pallor. We have used the term paranaemia to indicate the condition. 



In Chapter III., section Effects on the Blood (p. 75), we have 

 shown that this apparent anaemia has been carefully studied by 

 W. M. Strong, who considers that this pallor is really caused by the 

 deposition of pigment in the epidermis. This pigment renders the 

 skin opaq^ue to the red rays contained in sunlight, and hence the 

 colour reflected therefrom appears to the eye white. 



In diagnosing this condition care must be taken to exclude true 

 anaemia by a count of the red cells in the blood and an estimation 

 of the haemoglobin. 



De Langen believes there are real differences between the blood of Euro- 

 peans in the Tropics and at home: a shift to the left of Arneth's count, dimi- 

 nution of cholesterin, increase in blood sugar. He attributes to the hyper- 

 glycaemia the low fever so often found in the Tropics. 



LEUK>EMIi^. 



Leucoeythemia cannot be said to be very rare, at all events in our 

 experience, and may be either spleno-medullary or lymphatic in 

 type. It is most necessary to remember the possibility of the 

 occurrence of this disease, and to make it a rule to examine the blood 

 microscopically before performing splenic or hepatic puncture in 

 cases bf splenomegaly. 



Pseudo-leukaemia and Banti's disease are also known. 



