The diagnostics and treatment of tropical diseasesStitt, E. R. (Edward Rhodes)
Science
The diagnostics and treatment of tropical diseases
Stitt, E. R. (Edward Rhodes)
Tropical medicine
=Plasmodium Vivax.=—In fresh, unstained preparations, taken at
the time of the paroxysm or shortly afterward, the benign tertian
schizont, or nonsexual parasite, is seen as a grayish white, round
or oval body, whose outlines cannot be distinctly differentiated
from the infected red cell. They are about one-fifth of the
diameter of the red cell and are best picked up by noting their
amoeboid activity. In about eighteen hours fine pigment particles
appear and make them more distinct. After twenty-four hours the
lively motion of the pigment and the projection of pseudopod-like
processes, in a pale and swollen red cell, make their recognition
very easy. When about thirty to thirty-six hours old the amoeboid
movement ceases. Approaching the merocyte stage the pigment tends
to clump into one or two pigment masses and one can recognize
small, oval, highly refractile bodies within the sporulating
parasite.
The gametes or sexual forms do not show amoeboid movement, but
the fully developed gamete, which is generally larger than the
red cells, has abundant pigment, which is actively motile in
the male gamete and nonmotile in the female. The male gamete
is more refractile, is rarely larger than a red cell and shows
yellow-brown, short rod-like particles of pigment. About fifteen
minutes after the making of a fresh preparation these male gametes
throw out four to eight long, slender, lashing processes, which
are about 15 to 20 microns long. These spermatozoon-like bodies
now break off from the useless parent cell and with a serpent-like
motion glide away in search of a female gamete, knocking the red
cells about in their passage through the blood plasma.
The female gamete is larger than a red cell, is rather granular and
has more abundant dark-brown pigment than the male.
=Stained Smears.=—In dried smears, stained by some Romanowsky
method, as that of Wright, Leishman or Giemsa, we note small
oval blue rings, about one-fifth of the diameter of the infected
yellowish-pink erythrocyte. One side of the ring is distinctly
broader than the rather fine opposite end, which seems to hold
a round, yellowish-brown dot, the chromatin dot, and has a
resemblance to a signet ring. These small tertian rings of the
nonsexual parasites (schizont) are seen about the time of the
commencement of the sweating stage of the paroxysm. Two chromatin
dots in the line of the ring are rare as is also true of more than
one ring in a red cell.
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