Volume 1

A case of malarial fever, showing a true parasitic relapse, during vigorous and continuous quinine treatment / by Sir Ronald Ross and David Thomson.

  • Ronald Ross
Date:
1912
Catalogue details

Licence: Public Domain Mark

Credit: A case of malarial fever, showing a true parasitic relapse, during vigorous and continuous quinine treatment / by Sir Ronald Ross and David Thomson. Source: Wellcome Collection.

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    Patient E. E., age 65. Half-caste, born in Canada. Occupation, seaman. : . History prior to admission. Patient had been to sea for forty-five years, and had sailed to most parts of the world, including India, Japan, etc. He had a slight attack of malarial fever six years ago, but it did not trouble him much. In May, 1911, patient sailed up the Amazon river for the first time. He arrived at Porto Vellho on 17th May, 1911. There he left the ship and took a post ashore as foreman of a gang of labourers. He got an attack of fever on the 2nd of June, and was very ill, and states that he had dysentery as well. He was in bed for a month and was getting quinine thrice daily all the time. After this he remained well for two months, during which period he had quinine, according to his own statement, ‘only once in awhile.’ He had a second attack of fever in September, but this attack was not quite so severe. He then sailed down the river to Manaos and took a ship to England. He was ill during the whole of this voyage and got quinine only once or twice a week. He was admitted to the Tropical Ward of the Royal Southern Hospital, under our care on the 23rd October, 1911. The duration of his illness before admission was, therefore, . 159 days. Details of case after admission. These are shown graphically on the accompanying chart. On admission patient had fever, and the blood examination revealed a mixed infection of benign and malignant tertian malaria. A few crescents were present (about 16 perc.mm.) The blood showed marked auto agglutination of the red cells and nucleated and stipuled basic red cells were numerous. The haemoglobin was only 40%. There was no appreciable enlargement of the liver or spleen. The patient was very weak and somewhat emaciated, and had a tendency to be slightly delirous and incoherent in his speech. Quinine hydrobromide in liquid form was administered in doses of ten grains thrice daily, by mouth. This reduced the asexual parasites to below the detectable limit in thin films, in five days, that is, about two days longer than usual. This dosage of quinine was continued for seventeen days, during which period the temperature remained normal. From the 3rd till the 9th November the blood was not examined; on the 1toth November, however,
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