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SECTION IV.

THE BLOOD CHANGES IN KÁLA-ÁZAR AND ANCHYLOSTO-
MIASIS.

    Although anæmia is the essential symptom of anchylosto-
miasis, and one of the main symptoms of kála-ázar, yet the
changes in the blood might be expected to be different in the
two cases, because the anæmia is produced in entirely different
ways in the two diseases. Thus, in the case of the former
disease, the anmia is brought about by the sucking of the
blood out of the mucous membrane of the small intestine by a
large number, usually from 500 to 1,000, or even 3,000, of very
small worms, which gain access to the intestinal tract in the
water and food, but cannot increase in number while in the
body. In the case of kála-ázar, on the other hand, as has
been shown in Section III, page 45, the anæmia is in direct
proportion to the fever, and is doubtless due to the blood being
destroyed inside the body by the malarial organisms, which
cause the fever. In the former case, all the constituents of
the blood are equally lost to the economy, although they
cannot all be replaced with the same rapidity. In the latter
case, the corpuscular elements of the blood only are destroyed,
while the albuminous fluid in which they float is not directly
affected, and what is of even more importance, the haemo-
globin, or coloring element, is not lost to the system, but, as
will be proved in Section V, is stored up in the liver, spleen,
etc., and is available for stocking fresh red corpuscles, as
these are renewed by the recuperative powers of the tissues.

    I could, however, find very little in the way of examina-
tions of the blood in such of the literature of anchylostomiasis
and malarial fevers as was available to me, so I determined to
make as complete an examination of it as possible in these
two diseases, and it was hoped that in this way it might be
determined in what respects the blood changes differed in the
two diseases, and if the differences were sufficiently marked

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