THE BLOOD 



1151 



Kind of Corpuscles. 



Da Costa. 



Billings. 



Christo- 

 phers and 

 Stephens. 



Bastianelli. 



Polymorphonuclears . . 





65-04 



50*2 



39*0 



Large mononuclear and tran- 













15-94 



16*90 



31-4 



41*0 



Lymphocytes . . . . 



15-33 



16*90 



18*1 



19*1 



Eosinophiles 



0-83 



0*96 



0*4 



0*6 



It must be remembered that this relative increase in the mono- 

 nuclears has been noted in other protozoan infections. 



Phagocytosis is particularly seen in the large mononuclear and 

 transitional leucocytes, and to a less degree in the polymorpho- 

 nuclear leucocytes and very rarely in the eosinophiles. In these 

 cells clumps of pigment and the residue left after segmentation of 

 a schizont are not uncommonly seen. If, however, something 

 abnormal takes place in the red corpuscle, a phagocyte may engulf 

 it and its parasite, or only the parasites if they have escaped from 

 the red cell, or only the debris of the red cell. 



Vacuolization and diminution of the staining power of leucocytes 

 are to be seen. Myelocytes are said by Da Costa to be found in sub- 

 tertian infection up to 0'5i per cent. Eosinophiles diminish during 

 the paroxysm, and increase during the apyrexia. 



HEMOGLOBIN. — 'This is, of course, reduced, but the colour index 

 may vary sometimes, being less than normal, Ross and Thomson 

 find that it falls markedly with an attack of fever, but rises rapidly 

 during convalescence. 



The Specific Gravity of the Blood. — -Diminution of the den- 

 sity of the blood begins at the onset of the attack, and becomes more 

 marked as it proceeds, and may amount to a diminution of 6-2 

 degrees. This fall is probably due to destruction of red cells and 

 the breaking up of large parasites, which more than balances any 

 loss of liquid by vomiting, diarrhoea, sweating, and polyuria. 



The diminution is most marked in full-blooded persons, in primary 

 affections, and first attacks, less in later attacks, and least in chronic 

 malaria. The density recovers after treatment by quinine. 



Chronic Malaria. — In chronic malaria there is a leucopenia and 

 a marked decrease in the numbers of the red cells, which is but little 

 affected by febrile attacks. 



Post-malarial Anemia.— Bignami points out that there are cases 

 in which, in spite of the cessation of the malarial fever, the anaemia 

 tends to progress, and these he calls post-malarial anaemias. They 

 are generally induced by age, malnutrition, overwork, pregnancy, 

 nursing, etc., and are not due merely to the malarial infection. 

 Bignami divides these into four types, according to the characters 

 of the blood. 



