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PNEUMONIA, PLEURISY AND BRONCHITIS.
Of these diseases 13 were examined and in 9 malaria was present. None of the cases were fatal. It is a question as to whether a good deal of what used to be known as "influenza" in this Colony was not malaria with a lung complication, the pains in the muscles, &c. being due to the malarial element.
ASTHMA.
It is an interesting fact that malaria has been recognised as a cause of this disease long before the parasitic days though no one has yet attempted, as far as we know, to explain the pathology. The disease is not very common here. Seven cases were examined and in 6 the malarial parasites were present. Hypodermics of quinine and morphia we found the best treatment.
NEURALGIA, &c.
Malaria has long been looked upon as a cause of inflammation of nerves or of effusion in their sheaths. These, not being exactly hospital cases, did not come much under observation and we can- not say
if this is a common form of malaria here. Two cases only of neuralgia were examined, one of which was positive. The negative one subsequently turned out to be due to syphilis. Two cases of sciatica were examined, both being of malarial origin. They were so obstinately recurring that both patients were invalided. Hypodermics of quinine in the line of the sciatica nerve is the best treatment and it is just sufficiently painful to prevent malingering for the disease being one entirely of subject- ive symptoms offers a fair field for a rest in hospital.
COLITIS.
Only one case of this disease came under treatment and was most interesting.
The
Case 19.-A German sailor was sent in by the medical officer of the steamer to be operated on for appendicitis which the symptoms pointed as the cause of the illness in a marked manner. routine blood examination, however, showed malaria and the case was treated with quinine and saline purges. He recovered rapidly but had a return of all the symptoms whilst in hospital but eventually rejoined his ship quite well. On each occasion the stools were very typical being full of "jelly like"
mucus.
DIABETES.
The only case of this kind, which came under our notice, is recorded as a curiosity, the disease itself being very rare indeed in this hospital. The case was that of our Hindu cook and interpreter, an old Government servant of some 20 years' service and a subject of diabetes for over 8 years. The disease seems to have absolutely no effect on him although when in hospital with his malarial attack he was passing over 4 grains to the ounce.
ALCOHOLISM.
Only a few cases were examined, two of which were positive and one negative. We have not had many opportunities of investigating these cases for malaria but we think there is little doubt that over-indulgence in alcohol, with the exposure which generally goes with these cases, helps to preci- pitate an attack of malaria in anyone who is already infected with the disease.
CHYLURIA.
Case 20.-This case was interesting as the fever was In a very few days, under quinine, the fever disappeared. the filaria both in the blood and the urine of this patient. of thymol-recommended by Indian authorities for this the patient insisted upon returning to Jaqan.
due to the malaria and not to the filaria, We had a very good opportunity of seeing We had hoped to be able to try the effect disease-but as soon as the fever was over
PURULENT MENINGITIS.
Only one case of this disease occurred. Case 21.-A Chinaman from Manila was brought to hospital in a dying condition and without any history of his illness. The presence of malaria in his blood led to the belief it was a case of malarial coma. An examination after death showed extensive suppuration at the base of the brain. extending up both sides and without any primary cause apparent either in kidneys, liver or elsewhere. Although it does not come under the head of a clinical report, another case might here be mentioned which, by a curious coincidence, came under the notice of one of us (Dr. BELL) a few days after at the public mortuary. As no internal cause of death was evident the brain was examined and a precisely similar condition to the above was found. A smear from the spleen also showed recent malaria. Is it possible to get purulent meningitis as a result of wholesale blocking of the vessels of the brain or meninges by the malarial parasites ?