The diagnostics and treatment of tropical diseases — John Shaqi
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
6. _Cultivation of parasite._—As to cultivation of malarial
parasites. Bass takes from 10 to 20 cc. of blood from the malarial
patient’s vein in a centrifuge tube which contains 1/10 cc. of
50% glucose solution. A glass rod, or a piece of tubing extending
to the bottom of the centrifuge tube is used to defibrinate the
blood. After centrifugalizing there should be at least one inch
of serum above the cell sediment. The parasites develop in the
upper cell layer, about 1/50 to 1/20 inch from the top. All of the
parasites contained in the deeper-lying red cells die. To observe
the development, red cells from this upper 1/20 inch portion are
drawn up with a capillary bulb pipette.
Should the cultivation of more than one generation be desired,
the leucocyte upper layer must be carefully pipetted off, as the
leucocytes immediately destroy the merozoites. Only the parasites
within red cells escape phagocytosis. Sexual parasites are much
more resistant. Bass thinks he observed parthenogenesis. The
temperature should be from 40° to 41°C. and strict anaerobic
conditions observed. Aestivo-autumnal organisms are more resistant
than benign tertian ones. Dextrose seems to be an essential for the
development of the parasites.
Bass considers that _P. vivax_ has a disc-like structure which
enables it to squeeze through the brain capillaries while adult
schizonts of _P. falciparum_ have a solid oval form which causes
them to be caught in the capillaries.
The Thompsons have rather simplified the method of Bass. They draw
10 cc. of blood into a test tube containing the usual amount of
glucose solution. They then defibrinate the blood by stirring with
a thick wire for about five minutes and remove the wire with the
adhering clot. They then pour this defibrinated blood into several
small sterile test tubes, which should contain at least a one-inch
column. Rubber caps are adjusted over the cotton plugs and the
tubes placed in the incubator. They note the tendency of cultures
of _P. falciparum_ to agglutinate which is not true of _P. vivax_.
They think this agglutination the great cause of the plugging of
capillaries in pernicious malaria. They note 32 merozoites as
maximum number in sporulation of _P. falciparum_ while _P. vivax_
has usually 16 or more, but never as many as 32.
This would explain the shorter incubation period of malignant
tertian. The pigment of _P. falciparum_ clumps much earlier in the
developing schizont than that of _P. vivax_ and is much coarser and
more discrete.
While Bass thought he noted parthenogenesis in cultures others have
failed to observe any evidence of it.
7. _Immunity._—As to immunity. There is no real immunity to
malaria, it is a continuance of the infection, but the parasites
are not in sufficient numbers to give rise to fever. If, however,
the patient becomes chilled or fatigued or otherwise depressed,
fever results.
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