MENTAL DISTURBANCES, disorders of the special senses, peripheral neuritis, cerebral and spinal paralyses may occur as post-malarial manifestations. As a rule, their tendency is toward complete recovery.
Two cases of aphasia due to malaria. The treatment and the result showed the correctness of diagnosis. Sornapa S. Lingayet (Indian Lancet, Jan. 16, '97).
Death caused by urinary suppression in malarial hematinuria in 90 per cent. of all cases. Vogel (Indian Lancet, Nov. 1, '97).
Six cases of paralysis of the bladder oc curring in the course of malarial affec tions. Patients were all men, and mostly those past middle life. Sometimes the paralysis came on in the course of ma larial fever; in other instances it was the first symptom of malarial infection. Once it had appeared, it did not subside until the malarial trouble was entirely cured, and then it disappeared as suddenly as it had set in. Marion (N. Y. Med. Jour.; Medical Bull., Dec., '97).
Retinal lesions found in the graver forms of malarial poisoning: swelled ar teries and veins, perivascular cedema, and sometimes swelling of the papilla, itself.
In the blood of the retinal vessels were found the well-known changes in the red blood-corpuscles characteristic of malaria. Guarnieri (Arch. per la Sci. Med., No. 1, '97).
Diagnosis between quinine and malarial amblyopia can only be made by an ex amination of the fundus of the eye. By this method retinal alterations are found like those observed in patients suffering from malarial disease, or simply ischmmic troubles, as in cases of quinine intoxica tion. It is very rare that arnaurosis due to malaria shows a tendency to remain and becomes permanent, while quinine amblyopia, even when it is not perma nent, persists for a considerable time. Ischmmia of the disk constitutes the true pathognomonic sign of cinchonic intoxi cation. If nerve-atrophy is accompanied by marked contraction of the retinal ves sels, and the ocular trouble has immedi ately followed the malarial manifesta tions which call for necessary energetic quinine medication, the patient is suffer ing from quinine arnaurosis. Juan
Santos (N. Y. Med. Jour., May 14, '98).
All malarial lesions of the eye originate in circulatory troubles. They are under the classified head: (1) neuritis; (2) retinal hoemorrhages; (3) retinochoroi ditis; (4) effusions into the vitreous, Certain obscure affections noted are sud den and persistent amaurosis, without, visible fundus change, periodical amauro sis, sudden arnaurosis ending in atrophy, persistent central scotoma, and periodical blue vision. T. M. Yarr (Brit. Med. Jour., Sept. 24, '98).
The disturbances of speech mostly ob served in malaria occur in the form of ataxic aphasia. A simple difficulty of speech or stammering is of rare occur rence. Disturbances of speech are more frequently observed in connection with the malignant forms of the disease. They occur either together with the paroxysm or at the height of the dis ease; rarely at the end of it. Malarial aphasia is more frequent in men than in women. It is frequently accompanied by paralysis. Malarial aphasia is usu ally temporary, is of short duration, and entirely recovered from. I. E. Tika nadze (Phila. Med. Jour., June 29, 1901).
N.-, •t ut .u0 pre-ent-. ino•t of the •—• LI ohm.. in other omenlie 1..-- • .1 neuriti-. lu the tliaerential e 1.1,110W ing ;Are 1,t In malarial neuritis: 1. The ••• the ilisea-o is intermittent.
• iv ;ell, it tenees corresponding to t• ' di a 2. Th, r. ...•••• are frequently preserved, and •? • \ill be exa!_fgerated: tremor.
• and a thetoid movements in the tr• it Innis are not uncommon. and at I -ft there may be bulbar symp , -11-. 3. The sensory distilfbances are iri..111.1r and dissociated. sometimes uped according to the wearing of L.- or stockings. and frequently sug zisti‘«U hysteria. 4. The rarity of •.eniplete reaction of deg,eneration in the zed mu-eles. 5. The frequency of .ust motor and trophie disturbances. 6. I Le alim•st constant failure of sphincter tr,oible. These are the chief directions ulii,11 malarial neuritis may be sepa rated from other forms of neuritis.