224 
MALARIA 
plasma there was an increase in fibrinogen 
at the height of each malarial paroxysm 
with an absolute decrease of albumin and 
that these conditions were reversed during 
the apyrexial period. 
Chopra, Mukherjee and Sen (1935) 
studied the serum proteins in human cases 
during and after the paroxysm and found 
that during the rigor there was a consider¬ 
able decrease in the albumin and a slight 
increase in the euglobulin while the pseudo¬ 
globulin remained practically normal. 
After the rigor had subsided the changes 
in proteins were found to be similar to 
those found during the rigor but the 
changes were less marked. 
The increase of euglobulin in malaria 
is associated with the development of 
Henry’s melano-flocculation test for the 
diagnosis of the disease. Chorine and his 
co-workers (1934, 1938) and a number of 
others have shown that this reaction is not 
dependent upon antigenic properties of 
melanin specific to malaria, but is due to 
the flocculation of euglobulin with melanin 
as an indicator. Chorine and Gillier 
(1934) showed that the flocculation de¬ 
pended upon the molecular concentration 
of the serum, flocculation being prevented 
by the solubility of euglobulin if the mo¬ 
lecular. concentration was increased. On 
the basis of this work, Proske and Watson 
(1939) developed a protein tyrosin color 
test for the diagnosis of malaria in which 
they completely precipitated the euglobu¬ 
lin by the use of 13.5 per cent sodium 
sulfate. 
The blood urea apparently undergoes no 
significant change in malaria unless there 
is severe damage to the kidneys either in 
malignant malaria or associated with 
chronic malaria or blackwater fever. 
One of the interesting phenomena asso¬ 
ciated with malaria, and probably related 
to the blood proteins, is the development 
of positive reactions to serological tests for 
syphilis. Although a number of conflicting 
reports have appeared from time to time, 
Kitchen, Webb and Kupper (1939) have 
shown that positive tests are obtained regu¬ 
larly during some period of the clinical 
disease. The duration of the seropositive 
period varied considerably but was as much 
as four weeks in nearly half of the cases. 
The percentage of positive reactions was 
highest during the third week following the 
last previous paroxysm. These findings 
emphasize anew the non-specificity of the 
present serological tests for syphilis. 
Physico-chemical changes which are 
probably related to the blood proteins have 
been found in both hqman and monkey 
malaria. Sinton, Orr and Ahmad (1928), 
studying human cases, found a slight de¬ 
crease in the surface tension of the serum 
during the rigor with a return to normal 
afterward. In three out of four cases they 
observed a rise in the refractive index of 
the serum during the rigor. Kehar (1936) 
studied these and other physico-chemical 
changes in monkeys infected with P. 
knowlesi. He found that the surface ten¬ 
sion of the serum decreased considerably 
as the disease progressed, and that there 
was a slight but persistent rise in the re¬ 
fractive index during the acute period of 
the infection, but that no variations were 
observed in the specific gravity of the 
serum. 
The sedimentation rate of the erythro¬ 
cytes in malaria has been studied by a few 
investigators. Radosavljevic and Ristic 
(1926) found that during the rise of tem¬ 
perature there was a decrease of the sedi¬ 
mentation rate associated with a decrease 
of total plasma “albumen” and an increase 
of plasma fibrinogen. During the fall of 
temperature and in the following fever- 
free period the sedimentation rate increased 
to a level above normal while the “total 
albumen” and fibrinogen showed only a 
partial return toward normal. During the 
active stage of the disease these changes 
became progressively more marked, but 
returned to normal gradually during spon¬ 
taneous remissions or more quickly after 
quinine treatment. They found these 
changes not only in the clinical stages of 
the disease but also in the incubation 
period and just before relapses, and be¬ 
lieved that they were related to the sporu- 
lation of parasites rather than to the mere 
