Observations on the diseases of British Malaya / by C.W. Daniels.

  • Charles Wilberforce Daniels
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the diseases of British Malaya / by C.W. Daniels. Source: Wellcome Collection.

    18/96 page 10
    [ 10 ] action of Quinine dissolved in the blood serum on the parasites. The result of giving large doses where small doses fail and even increasing both the frequency and the amount of the doses in severe cases almost to an unlimited extent is usually found to be highly satisfactory. In two of the fatal cases intramuscular injections of 5 grains were given every two in one case and every 3 hours in the other on the day on which death occurred. Coma was not present in all the fatal cases; death in several seemed to be the result of collapse or slow cardiac failure. Intense congestion of the alimentary tract was present in three cases and in one other, though neither ulceration nor marked congestion was found at the autopsy blood had been passed per rectum in quantities two days before death. The frequency of Epistaxis in Malaria is well known. The two organs most commonly enlarged in Malaria are the liver and spleen. In these cases the average weight of the spleen was 476 grams., in two cases it was under 300 grams., and in three under 400; in two it was over 700, in one over 600, and in four over 500. As the normal weight varies from 150 to 250 grams., it will be seen that the enlargement was slight in two and moderate in three more and in none extreme. As compared with the cases of Enteric occurring in the same race, Chinese, there is little difference, as in these the average weight was 380, one of the spleens being only 1g0 grams. ‘The others were respectively 270, 435 and 635 grams. In the malaria cases the average weight of the liver was 1,568 grams., or little above the average normal weight, and in only four was it over 1,800 grams., two were under 1,200 grams. The enlargement of the liver is far less marked than in Pneumonia, but slightly more than in the Enteric cases here, as these had an average weight of 1,505 grams. There were no cases of Hemoglobinuric (Blackwater) Fever, even from the intensely malarial Gombak district. At Klang, near the coast, one case was reported by Dr. Watson. The course of the disease and the character of the urine were similar to those in a mild attack of Blackwater Fever in Africa. The so-called Leishman Donovan bodies were not observed. No cases clinically resembling the disease associated with these parasites were seen by me. I am informed that amongst Tamil immigrants cases do occur with the association of enlarged liver and spleen and irregular pyrexia unaffected by Quinine. These have not been seen by me or examined for these bodies. PIROPLASMOSIS.
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