1 1 72 



THE MALARIAL FEVERS 



bacteriological tests for Micrococcus melitensis and its allies are 

 absent. Finally quinine effects a cure. 



Typhus-like Type. — The cases exactly resemble typhus fever, 

 but malarial parasites are often present in the blood, and the disease 

 yields to quinine therapy. 



Cerehro-Spinal-like Type. — The symptoms are those of epidemic 

 cerebro-spinal meningitis, but the cerebro-spirial fluid is clear, though 

 its pressure may be increased; its cellular contents are normal in 

 number and character, while meningococci are absent and the blood 

 shows malarial parasites. The spleen may or may not be enlarged. 



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Fig. 624. — Atypical Subtertian Malaria simulating Typhoid Fever. 



Haemocultures and serological reactions for germs of the Enteroidea 

 group of fevers were negative. 



Sleeping-Sickness-like Type.- — This, which is rare, is characterized 

 by low fever, slight trembling of the hands and tongue, and progres- 

 sive general weakness, drowsiness, and occasional convulsions. 

 The lymph glands in the neck are not enlarged, and the cases may 

 occur in regions where sleeping sickness is unknown. Malarial 

 parasites may be hard to find, but quinine in large doses cures the 

 affection. 



Yellow -Fever -like Type. — This is characterized by fever, without 

 rigors, severe headache, flushed face, pains in the body, pulse quick, 

 full, and bounding at first, severe vomiting, tenderness in the 

 epigastric region, and slight albuminuria. On the third day the 

 temperature falls from 103° to 100° F., and the symptoms abate, 

 while the patient feels better; but the temperature rises again, 

 jaundice appears, the pulse slows to about 60-70 per minute, dark 

 brown vomit appears containing red blood-corpuscles. The 

 symptoms may get worse, the jaundice may deepen, and death 

 ensue. Subtertian parasites may be present in abundance in the 

 blood, and quinine may be ineffective unless given in massive 

 doses. 



W eiV s-Disease-like Type. — Cases like Weil's disease, with cutane- 

 ous haemorrhages, are occasionally malarial, and may end fatally. 

 The mild type of camp jaundice may also be simulated by malaria, 

 but this is rare. 



