Medical Officers of the Army of India.
153
‘allied to another genus of the same group, called Klossia (as well as to V. Danielevsky’s Trypano-Somata ). As the
‘ a u t h o r t h i n k s , H œ m a t o p h y l l u m M a l a r i œ ,l
i k e t h eC
o c c i d i u m o v i f o r m e
o f t h e r a b b i t ’ s l i v e r , d o e s n o t d e v e l o p a n y
‘resting-spores within the living organism. Probably the daughter-spheroids do not transform in the human body
‘into sporoblasts, but only give generations of amæboid bodies and encysted forms (crescents), which spread over
‘the blood of the individual. The spores are generated and ripened only after a prolonged sojourn in the soil.
‘Such a supposition might explain a pronounced miasmatic nature of the malarial virus, which can be inoculated
‘ s o l e l y b y w a y o f a d i r e c t i n t r o d u c t i o n i n t o t h e b l o o d , ’ p . 4 6 9 . ”
(N.B. —The allusion to Coccidium shows that the comparison in the text, had occurred to others than myself.
No mention is made here of the flagellated organisms. The next remarks refer to ‘p h a g o c y t e s ’ , w h o s e w i d e
influence in pathology Professor Metschnikoff has long forcibly upheld.—H. V. C.)
“ In the spleen of a patient dying of malarial meningitis, there were found only a few microphagi (leucocytes)
containing red blood-corpuscles with the microbes, and masses of a dark-brown pigment ; but a great number of
macrophagi (large cells of the splenic pulp), containing red blood-corpuscles in various stages of dissolution and
coccidia in early evolution-forms, as well as isolated heaps of melanine (black pigment) and smaller granules of
pigment. Similar macrophagi were abundant in the liver of this and another patient. Hence the author con-
cludes that ‘t h e h u m a n o r g a n i s m s t r u g g l e s a g a i n s t t h e m a l a r i a l m i c r o b e w i t h h e l p o f d e v o u r i n g c e l l s , m a i n l y w i t h
help of the macrophagi.’ ”
( N.B. —Leveran had previously made similar post-mortem observations, l. c., p. 59. The bodies in Plate IX B.
Fig. 15, doubtless correspond to the above, see also a coloured drawing of the hepatic blood from a fatal case of
malarial melanæmia recorded in Trans. Med. Phys. Soc. of Bombay No. VIII, New Series, 1886 p. 30.—H. V. C.)
“ Some facts (concerning partly malarial, partly relapsing fever) led Professor Metschnikoff to believe ‘ that the
malarial parasite in its free state is not devoured by phagocytes, possibly in consequence of its excreting a succus
on its surface, which, as it were, paralyses the phagocyte. Hence its proliferation in the blood may proceed
uninterruptedly, to a certain extent, but with its entrance into the red blood-corpuscle the microbe loses its power
of resistance to phagocytes, and then the latter, which generally devour ‘ enfeebled ’ red corpuscles in the human
body, begin to devour also the corpuscles enfeebled by the coccidia.’ ”
(N.B. —The Bombay observations demonstrate an amæboid activity which at Odessa could not have been known ;
and they also disprove any notion that even a multitude of organisms in the blood necessarily entails the febrile
state. Reference being here made to relapsing fever, I desire to point out that in 1878 I had watched the destruction
of a spirillum by a leucocyte, and figured and described the phenomenon, which is alluded to at page 366 of
my work on Spirillum Fever, London, 1882. It may be added that Professor Metschnikoff has shown, by experiment
on the monkey, that spirilla thus taken up by leucocytes still retained their infecting power ; and this fact, with the
occasional free appearance of the spirilla, is considered to explain the recurrency of the febrile attacks,— vide L O N D .
MED. REC., October 1887, para. 7369.). According to this view, the relapsing tendency of both spirillum and malaria-
fever would be similarly explicable.— H. V. C.)
3. Relations of the Organisms. —These, as inferred from the foregoing
data, may be ranged as follows :
—
Comparative frequency of the pigmented bodies. My 7 cases were
e x a m - i n e d o n c e , t w i c e , o r o f t e n e r o n 1 2 7 d a y s , t h e f r e e c r e s c e n t s b e i n g n o t e d o n 7 2 ,
bare spheroids on 68, and the flagellated on 20 days ; undoubted pigmented
spots on or within the red blood-discs were not seen nearly so often as the free
organisms. These results are too contingent to have more than a limited value ;
yet with them may be usefully compared the experience of Laveran, who in 432
cases found crescents 107 times, spherules either free or sessile 389 times and
the flagellate bodies 92 times, adding that often the red corpuscles present small
clear spots which are probably incipient spheroids ; whilst, on the other hand,
Osler in 70 cases ascertained that the most common alteration in the blood of
malarial patients is presented by a pigmented structure inside the red corpuscle,
finding the crescents in 18 cases only, rosette-forms (? spheroids) in 8, and
flagellated organisms in 7. There hence appears a certain discrepancy which
remains for explanation ; and doubtless if the observations on blood-disc changes