220 
MALARIA 
ties and making them more cohesive, both 
to themselves and to surrounding tissues. 
The demonstrations of agglutination in 
pernicious malaria, therefore, suggest the 
presence of an antibody whose action be¬ 
comes manifest after a proper interval of 
time and when the parasitic population in 
the blood is large enough to afford op¬ 
portunities for contact between numerous 
parasitized red blood corpuscles. If this 
explanation is correct, the prevention of 
intravascular agglutination would seem to 
require early, intensive and adequate 
chemotherapy in order to prevent the in¬ 
crease of the parasitic population to the 
critical level. 
In summary, then, there are many strik¬ 
ing similarities, as revealed by pathologic 
studies, between malarial and bacterial in¬ 
fection. If the conclusion is correct that 
the two types of infection are essentially 
similar, a better understanding of malaria 
should develop from the further applica¬ 
tion to its study of ideas and methods which 
are now well established for bacterial infec¬ 
tions. 
Figs. 1-6 incl. Photomicrographs from sections of patient (#3883) who died from untreated pernicious 
malaria. Fixation in Zenkers solution (without acetic acid). Stained with hematoxylin-eosin azure II. 
Fig. 1. x 1575. Note the accumulation of parasitized erythrocytes in a capillary of the left myocardium. 
Fig. 2. x 1250. Note the scarcity of parasitized erythrocytes in a small renal vein. 
Fig. 3. x 1300. A capillary in the mucosa of the ileum is obstructed by parasitized erythrocytes 
whereas a contiguous venule contains no parasitized red cells in the focal plane examined. 
Fig. 4. x 1150. Many parasitized erythrocytes are concentrated in the red pulp of the spleen. Note 
the absence of conspicuous phagocytosis. 
Fig. 5. x 1425. A cross-section of a pulmonary vein showing an agglutinated clump of parasitized 
erythrocytes surrounded by non-parasitized red cells. 
Fig. 6. x575. A ‘‘depleted” splenic corpuscle surrounded by many parasitized erythrocytes in the red 
pulp. 
