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
Pools containing a border growth of grass or rushes are often
selected by anophelines for depositing eggs. The small fish
or tadpoles, which prey on the larvae, cannot work their way
through the obstacles and, again, petroleum oil cannot be easily
distributed in a network of grass. Anophelines of different species
and of different countries seem to vary in their selection of water
for depositing their eggs. We should not generalize but go out and
search for breeding places.
[Illustration: FIG. 15.—_Anopheles maculipennis (quadrimaculatus),
male._ (_After Castellani and Chalmers_.) From P. H. Reports.]
Anophelines seem to prefer small collections of water or sluggish
clear streams. The pools made by excavations following railway or
other similar construction are favorite breeding places. Proper
cultivation of rural districts makes the country more healthful and
Carter has stated that tile drainage is the key to rural malaria
control.
The most practical method for the identification of anopheline
species is to collect the larvae and later to study the adults
which develop from the pupae. On the whole culicines do not seem to
object to foul collections of water while anophelines avoid such
breeding places.
PATHOLOGY AND MORBID ANATOMY
The pathological lesions are those connected with the destruction
of enormous numbers of red cells, not only each infected red cell
being destroyed but others not so parasitised. There has been an
idea that at the time of sporulation and rupture of the merocyte a
pyrogenetic toxin was given off and along and with this there were
haemolysins and endotheliolysins. Following Brown we are justified in
thinking that the malarial pigment (melanin or haemozoin) can act as
a haemolysin and by being taken up by endothelial cells bring about
their degeneration with associated capillary haemorrhages. All three
factors—red-cell destruction by parasites, haemolytic action on red
cells and capillary haemorrhages lead to anaemia.
[Illustration: FIG. 16.—Digestive tract of _Anopheles_ the stomach
of which is covered with numerous zygotes or oocysts of _Plasmodium
falciparum_. _c_, cloaca; _mt_, malpighian tubules; _o_, oocyst; _s_,
stomach; _sb_, sucking bladders or pumping organ; _sg_, salivary
gland. (MacNeal from Doflein, modified after Ross and Grassi.)]
The brain has a leaden hue caused by the black pigment. As
discussed under pernicious manifestations the blocking of the
capillaries may be explained in several ways. When examining
sections of a malarial brain one often encounters punctiform
haemorrhages.
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