288 
most common, but four, eight, and sixteen-forms are 
frequently seen, especially at the crisis. 
Free forms are derived from the intracorpuscular 
forms, and are usually arranged in groups of four, 
eight, or sixteen forms. After leaving the cell para¬ 
sites stain more deeply and sometimes appear slightly 
larger. In fresh films they exhibit more or less rapid 
movements and a vibratile action of the fine end. 
A flagellum-like process is sometimes present in this 
position, but can rarely be made out in stained films. 
The chromatin of a parasite consists of (i) A dense 
mass, the nucleus proper, which is always present ; 
(2) A ragged lighter staining extension of this, which 
can generally be made out in all well-stained specimens; 
and (3) A minute punctiform mass, not always present, 
the so-called blepharoplast. 
Changes in the blood are profound, and consist 
of (1) Reduction in red cells to 2,000,000 or less; 
(2) Reduction in haemoglobin to a less extent ; 
(3) Leucocytosis, the number of cells reaching 50,000 or 
more as against the normal number of 7,000 to 8,000 ; 
(4) Appearances of nucleated red cells and rapid 
formation of new corpuscles. 
Post-mortem .—Parasites may be more numerous 
in the organs than in the peripheral blood, but are not 
always so. Thus while the number of corpuscles in the 
peripheral blood may be one to three per cent., in the 
capillaries of the heart there may be seventy per cent. ; 
in the lung, fifty per cent ; kidneys, forty per cent ; 
brain, eighty per cent.; spleen (trabecular veins), fifty 
per cent. The parasites are mostly small and spherical. 
The changes in the organs are most marked in the 
chronic cases. Ecchymoses occur in various organs, and 
according to Nocard all changes are due to great 
dilation of the capillaries by blood cells full of parasites. 
