Other Septic

Cases of malaria illustrating its vari ous manifestations. One commenced with symptoms of catarrhal dysentery 1\ithotit chill or variation of temperature, the symptoms exhibiting periodic exacerba tion. In Fawner case there was severe d:arrlicka, with two days' intermission and considerable malaise; in another di arrhrea of three weeks' duration. A ease of ulcerative stomatitis was cured on three occasions with quinine. Other eases presented tirticaria, conjunctivitis, leg ulcers, periodic pains in the knee, 13c11's palsy with periodic fever, paralysis of the extensor muscles of the right hand, . • - •• ;11 Al. IN I I I. 1 • 4 • - 1 1141 .1,0 e ;1, 1.• I old 3 • • I Moll,. .1111111m.

• • I • • •• • \ 1;.,...111e11 • ; . • ,t.] • o ,t1.0 ial blood off — .11,•.P....1.1, ,t1.1 of he,Ilthy) 4.. .1 11.11 l••1 • a t .. 1110 -.All AO .1 11/•14T.% 44 •• 4.110 r I 1.3.‘1,41'. le•• 4/ II +Ile III, re 1 corpii-ele. group ti inas-e, of from 3 to 3 .„ loo more. The lelleoeyle, li• 1.111. 1111.1 if they are included .1. I 1,4 ilia hey are stir /one free from cells, as if - t• .1 chetnotactie roulette arrange - ••• 1- to r met N11111 ill ;I Well-illade ...loll! 14, 1,,11 ((41ZZ.

- I 12. 19111L t ion in malaria studied dur i".: •11 epidemic in _\lgiers. In Olo• re-.1111, of the reaction not - I•ot lee l.iken of the color of the el I • 4 611611. e•pl[4(4ill I a tt en too _m•t4 tIn• coloration of the rodtr•e I ‘iolent agitation. xamilmtiop- of forty-four con - • lit, -c- reported. The obserN-a 1.. - n Id, both before and after P4 ri-i- the disease. Of these ex ,. oitoi - 47 gave ne[rative re,nits, mn'Af.d. 7 Were slOttly positive, 1 ga‘e a reaction of fair intensity.

od rarely fails to give a dif '.4111 jou 1-etween malaria and ty .. ..1••4 1- able When Ilaeter10 . niell o ;in- inaccessible or fail.

1 1:r on. I ompte, :-oc. Biol., Nov. S, t the agglutinating property P • itood of inalarial patients. The r 110 -erum of a healthy man - •• the blood of another healthy • •1 rot produce any ag7lutina of a healthy man ac rlo• ggItitinaling property when ;•/ • ie.! lb a manner which injures • rP1 1.Trr.Lec11--, The addition of a - 1 n f -odium chloride, eontainin,g per eent. of a quinine salt. to the 4.1 4 Cr i,e of a malarial patient de-tro;c-. the phenomenon of tion. This property may serve as a mean, of elleig1107-.1.--; bel Wee!! Hie ser11111 hlooll :I :111(I that of a malarial, person. In the malarial sc rim], so treated the failure of the ag glutinating phenomenon to 'Teal' 1. he presence of another in fections process. I). Lumonacio and Panichi (Hiforma Feb. 11, 12, and 13, 1902).

Analysis of 1!)5 eaRes of latent and masked malarial fevers. In the writer's series the blood.examination determined the diagnosis in all eases. One hundred

and fifty of these patients were found to he suffering from mstivo-autuinnal in fectious, 44 from tertian infections. and 1 from quartan infection. Fifty-five of these eases bad been wrongly diagnosed as chronic dysentery; 19 as chronic diarrhwa; and a list of some thirty dis eases is given for which these latent and masked eases of malaria were at first diag,nosed. The source of infection wac traced in ISO eases; 120 suffered from their first attack in the Philippine Is lands, while GO gave a history of having their first attack in Cuba. C. F. Craig (-Medical Record, Feb. 15, 1902).

The necessity for examination of the blood in making a diagnosi.s of malaria emphasized. In one series of 7000 cases suffering from various ailments malarial fever was stated to exist as the cause of admission. or as a complication thereof, in from 54 to 5,5 per cent. uf all cases, the maximum being in January and Feb ruary of each year, the minimum in July and Augnst. Upon the arrival of a competent pathologist the average fell to about 10 per cent.. and remained in that vicinity until the pathologist de parted, when it immediately rose again.

diagnosis reached during the time of the pathologist's stay had been by means of the microscope only, due al lowance being made for the recent use of antiperiodies. spontaneous conva lescence. ete. The diagnosis reached at other times was clinical. Ford (Medical _Record, April 5, 1902).

The writer divides his 66 cases into the following three classes: Tho.se in which the diagnosis of malaria was clear from the beginning, those in which the diagnosis was made only after a blood examination had been made, and those which were not malarial. A percentage of large mononuclear leucocytes above 12 is diagnostic of malaria. The lymphocytes are usually increased; the total leucocytic count is diminished; myelocytes are frequently- present to an a ppreciable extent; the erythroeytes are diminished; but the limmoglobin is not much diminished, the color index often being above 1. If, in a, malarial case, the fever is very recent, the blood changes may not have had time to de velop. If leucocytosis is present from any cause, the 12 per cent. of large mononuclears may appear not to be present. If the temperature is 103° F. or more when the puncture is made, the above conditions may not be found. D. W. Keiller Moody (Brit. Med. Jour., March 28, 1903).

Complications and Seguelx. — Com plications are, in great part, the result of mixed infections with other morbific agents, and comparatively few are due to the direct action of the malarial toxin, although some may arise from causes that are purely mechanical.