The diagnosis of latent malaria / by Hugh W. Acton and R. Knowles.

  • Acton, Hugh W. (Hugh William), 1883-1935.
Date:
1913]
Catalogue details

Licence: Public Domain Mark

Credit: The diagnosis of latent malaria / by Hugh W. Acton and R. Knowles. Source: Wellcome Collection.

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    = / in the urine and feces. As the relationship of hemoglobin to urobilin is known fairly accurately, the amount of hemoglobin that is destroyed can therefore be estimated. Roughly 25 gms. of hemoglobin yield 1 gm. of urobilin. Defective action of the liver is very marked in bilious remittent fever, and we believe that the glandular activity of the liver is frequently impaired in the other clinical forms of malaria. Hence the products of hemoglobin destruction cannot be properly dealt with by the liver, and are excreted by the kidneys as urobilin. Urobilin will accordingly appear in the urine in considerable quantities when the blood destruction has been great, 7.e., immediately after an attack of fever, or when the glandular activity of the liver is impaired, as in chronic malarial cachexia. It should be borne in mind that the presence of urobilin is not a specific test, comparable with that of finding parasites in the blood, but no more is a rise in temperature specific. As we are dealing only with the diagnosis of malaria in apyrexial periods, and as, with the exception of the anemias, malaria is the commonest cause in the tropics of blood destruction, therefore in such periods the presence of urobilin in the urine becomes a test for latent malaria. The Leucocytes. Thomson, (6) from his researches on the leucocytes in malarial infection, enunciated the following laws :— (1) During active malarial fever the number of the leucocytes in the peripheral blood is below normal and varies ane or less inversely with the temperature. (2) In malarial fever the curve representing the percentage of total mononuclear leucocytes is an exact inverse of the temperature curve. (3) In convalescent or apparently cured malarial cases, transient periodic leucocytoses occur in the peripheral blood, and these leucocyte fluctuations arise chiefly from a polynu- clear variation. He goes on to state :—‘‘ This post-malarial leucocyte phenomenon occurred without exception in the 40 cases examined, and would seem to be an infallible sign of previous malaria, since, so far, it has not been observed in any other disease.”’ | Our results bear this out. Figure 3, Table 4, shews the total leucocyte counts in percentages in 215 cases. One hundred and thirty
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