A study of some fatal cases of malaria / by Lewellys F. Barker.

  • Barker, Lewellys F. (Lewellys Franklin), 1867-1943.
Date:
1895
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Licence: Public Domain Mark

Credit: A study of some fatal cases of malaria / by Lewellys F. Barker. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    and in certain areas inside nearly every red corpuscle is a parasite with a central block of brownish black pigment. Along with these masses of infected corpuscles there are often found numerous mononu- clear macrophages crowded with blocks of malarial pigment like that to be seen in the infected corpuscles. There are places where the lumina of the veins appear to be narrowed near the base of the mucous membrane and as though blocked with macrophages damming back infected corpuscles. The arteries and veins of the submucosa are singularly free from infected corpuscles. The distribution of the parasites in the capillaries is very irregular; while in one area all of the capillaries may be closely crowded and distended with infected corpuscles, in other places quite near by the vessels may be almost entirely free from them. Besides the macrophages already described there are large red-corpuscle-carrying cells within the veins and ca- pillaries, filled with blood corpuscles which stain intensely with eosin. These cells contain large single nuclei which often send out processes among the red corpuscles in the protoplasm. Some of the smaller vessels appear to have their lumina entirely filled with huge cells of the kind describedj forming veritable casts. These cells must exercise considerable influence in obstructing the on-flow of blood. The surface of the mucous membrane in maoy places refuses to stain, and frag- mented nuclei are visible evidences of superficial necrosis. The Heart.—There is an excess of brown pigment at the poles of the nuclei of the muscle cells; otherwise there are no striking alterations. Cerebrum.—Only an occasional infected corpuscle can be made out within the capillaries; a few of the endothelial cells lining the capil- laries are phagocytic. Portions were saved from only one or two parts of the cortex. Thyroid Gland.—In the vessels of this organ as elsewhere in the peripheral circulation it is rarely that infected red blood corpuscles are to be seen. III. Case B.—Aestivo-autumnal malaria ; grave abdominal symptoms. John B., age 34, admitted to the Johns Hopkins Hospital, Sep- tember 10th, died September 16th, 1890. The following is Prof. Osier's clinical note of the case :