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macrophages seen in the organs in cases of malaria. In one of the cases malarial
pigment actually occurred in some of these cells along with the bodies under
discussion. I have never seen such large cells in fatal cases of malaria, and their
great development appears to be a feature of infection with the new parasites.

     In sections the bodies lying in the cell protoplasm showed very distinctly the
two chromatin masses and a clear space. This space appeared at first to be a
vacuole in which the parasite lay, but it is undoubtedly the body of the parasite
itself. The chromatin masses frequently occupied exactly opposite poles.
The outline of the intervening space was always in this case remarkably circular.
The appearance always strongly suggested a body resistant to shrinkage and
change of shape.

     The bodies were frequently seen singly or in small clusters in a pink stroma.
This stroma could nearly always be made out to be a severed process of a
macrophage.

     No bodies were found in red blood corpuscles (stained bright red by the
method employed) or lying free.

     Bodies were occasionally seen lying in leucocytes in the lumen of branches
of the portal vein. They were never numerous in this situation.

     The epithelium of the small bile ducts was unchanged. The bodies were
not present in the bile.

     In films and sections of the spleen similar cells to those in the liver capil-
laries were very conspicuous and contained the great majority of the parasites.
Large mononuclear cells containing parasites were more abundant than in the
liver. Occasionally a single parasite was seen in close connection with the end-
othelium or stroma cells. In the red cells no forms could be detected. Free
forms were never seen,

     In films of the red bone marrow the bodies were not so numerous in any of
the cases as in the liver and spleen. In smears made with care to avoid as far
as possible rupturing the large cells, the bodies were almost confined to the macro-
phages, some of which contained an immense number of them. They were also
contained in large mononuclear cells and isolated specimens were present in the
polymorphonuclear cells and finely grained myelocytes. No forms could be seen
in undoubted red cells. Megaloblasts were present.

     The constant presence of intestinal lesions and the marked character of the
changes found make the examination of the intestine of great importance. Smears
were taken of mucous membrane at the edge of ulcers and from congested
patches, as well as from the small red granulations noted in the description of
autopsy No 3. In this autopsy the tissues were preserved within one hour of
death so that they had changed but little.

     The examination of sections shows that, prior to ulceration, there is a form.
ation of granulation tissue in the mucosa, which may eventually be entirely
replaced by new tissue. The latter then encroaches upon the crypts and surface
epithelium, destroys them, and either projects as fungating granulations of