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
1. _Extracellular location._—It is usual to consider the parasite
as developing within a red cell and in this position to destroy the
red cell. Rowley-Lawson, however, thinks that the parasites are
exclusively extracellular and that they adhere to the red cells by
loop-like pseudopodia which encircle a portion of the red cell and
digest the haemoglobin of such an area.
2. _Relapses._—There are several views as to the etiology of
relapses in malaria. These views are taken up under relapses (see
page 35).
3. _Malarial toxin._—Nature of the toxic material thrown off by
the parasite at the time of simultaneous sporulation. Rosenau’s
experiments tend to show that there is a fever-producing toxin
thrown off at this time. Other authors have thought that a
haemolysin and an endotheliolysin were thrown off at the same
time. Brown considers that the pigment produced by the parasite,
in its metabolism of the haemoglobin of the red cell, may act as a
haemolysin, he having found that intravenous injections of haematin
were capable of producing marked anaemia. It is well known that
a far greater number of red cells are destroyed in a paroxysm
than would be accounted for by the actual percentage of red cells
destroyed by parasites. The endothelial cells take up actively this
malarial pigment or haemozoin and are damaged or destroyed thereby.
Haematin injections also tend to destroy leucocytes and platelets.
Rowley-Lawson is of the opinion that the greater red cell
destruction than would be represented by percentage of cells
showing parasites is explained by parasites migrating from cell to
cell so that many red cells may be destroyed by a single parasite.
4. _Transmission to larvae._—There has been an idea that
sporozoites might enter the ovaries and ova as well as the salivary
glands so that a second generation of mosquitoes might transmit
malaria. There is no proof that such a method is ever operative.
5. _Congenital malaria._—There has been some question as to the
possibility of congenital malaria. Heiser has recently reported the
case of an infant which showed crescents in its blood by the end of
one week from birth. The mother showed the same infection and the
child must have been infected through the placental circulation.
Clark in numerous examinations of the blood of the new-born
failed to find infection even when the mother’s blood teemed with
parasites. In one case where the child showed infection shortly
after birth there had been an accident to the placenta and he
believes that instances of so-called congenital malaria are to be
explained in this way.
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