MALARIAL
\malˈe͡əɹɪəl], \malˈeəɹɪəl], \m_a_l_ˈeə_ɹ_ɪ__ə_l]\
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By Princeton University
By DataStellar Co., Ltd
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Of, pertaining to, or producing malaria, as M. districts; produced by malaria, as M. paraplegia, M. symptoms. M. fever, fever characterized by its marked periodicity of recurrence, produced by the Plasmodium malariae. It occurs especially in the neighborhood of marshes or where a moist, porous soil has undergone rapid desiccation, as by being exposed to a hot sun or by being dug up. The presence of vegetable matter and heat favors its development. Infection may take place through air, water, or insect-bites. The Plasmodium inhabits the erythrocytes and causes their disintegration. Intermittent m. fever (Fever and ague, Chills and fever) occurs in paroxysms, each of which is marked by a severe chill followed successively by high fever and a profuse sweating, the duration of the attack being 1 to 10 hours. The attack is followed by a complete intermission of all the symptoms, but the paroxysm recurs again at regular intervals. Intermittent m. fever, develops mainly in the early spring and in the milder malarious districts. It includes (A) the quartan form, due to the Plasmodium malariae quartanae, an amoeboid body which becomes pigmented and then divides into sporules or new organisms. Sporulation occurs at the same time in all organisms of the same crop, thus producing the paroxysm. The life-cycle of the Plasmodium being 72 hours, the paroxysms recur every three days, if but one set of organisms is present (Quartan fever); while, if there are two sets of organisms present at once, there will be attacks on two successive days and intermission on the third (Double quartan); and with three sets of organisms there will be attacks every day (Triple quartan, Mild quotidian). In (B) the tertian form the parasite (Plasmodium malariae tertianae) is more actively amoeboid and its life-cycle is 48 hours, so that the attacks recur every other day (Tertian fever) or, if two crops of organisms are present at the same time, every day (Double tertian, Mild quotidian). In Remittent m. fever, occurring especially in hot climates (Panama fever, Chagres fever, African fever), particularly in the late summer or autumn (aestivo-antumnal form), there is no complete interval, but only a remission between the attacks; the febrile symptoms are more pronounced, there may be jaundice, haematemesis, delirium, and coma, or the symptoms of the typhoid state; and death often occurs with cerebral symptoms. This variety is due to the Plasmodium malariae quotidianae, forming small, very motile, biconcave discs, which after a short time are replaced by pigmented often flagellate crescents (M. crescents). Spotulation does not occur in all organisms of same set at once. Aestivo-autumnal fever comprises the True quotidian and the Pernicious tertian (by some ascribed to a distinct somewhat larger organism the Plasmodium malariae tertianae malignae). In all forms of m. fever the paroxysm is attended with enlargement of the spleen, which may finally become permanent; and in the later stages there is disintegration of the blood-corpuscles with the presence of free pigment in the blood (melanoemia). When long-continued, m. fever produces a state of anaemia and vital depression (M. cachexia). In many cases the febrile paroxysm are replaced by attacks of depression, neuralgic pains, congestion of the viscera, or other phenomena, whose distinguishing feature is their periodicity (masked ague). TREATMENT OF M. FEVER: quinine in large doses before the attack, associated with a mercurial purge or with opium and capsicum, and in severe remittent fever given hypodermically; cinchonidine; arsenic (especially in the non-febrile manifestations); salicin and salicylic acid; Warburg’s tincture; diffusible stimulants during cold stage.
By Alexander Duane
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