These two diseases influence each other only inasmuch as the symptoms of dysentery are usually more severe during the fever paroxysm. On this account the association of the dysentery may be overlooked and the case be improperly diagnosed as dysenteric malaria . In the great majority of instances, however, the anamnesis, the microscopic examination of the feces for amebse, and, in case of death, the localization of the disease in the large intestine, will indicate the diagnosis.
Cases have been repeatedly observed in which patients contracted smallpox while in the hospital for malaria . Laveran found that during the acute stage of variola the malarial parasites disappeared from the blood. Many of the combined cases were very severe. Prince observed a case of obstinate tertian which recovered suddenly after a variola.
* On working up the " Medical and Surgical History of the War of the Rebellion" Smart found that over 80 per cent, of the cases described as " typhomalaria" were nothing else than remittent malaria (quoted after Rho).
Malaria with scarlatina was observed by Sorbet in one case.
Malaria with relapsing fever was observed by Mamourski in one case. The diagnosis was assured by finding the malarial parasites and spirilla in the blood at the same time. After the exhibition of quinin, the former disappeared, though the latter remained.
Malaria with suppurative infections, like abscess, phlegmon, erysipelas, is not rarely encountered in the typhoid adynamic pernicious fevers as well as in cachectics.
These two affections are frequently combined during campaigns, when the scorbutus owes its origin to overwork, inadequate shelter, and insufficient or bad food. As to its specific cause, further investigations are necessary.
It is this combination which Haspel described in a masterly way under the name "Fievre putride scorbutique epidemique." Since then it has been seen during the Crimean war, as well as isolated in special places.
Malaria and beri beri were observed combined by Daubler.
It has been repeatedly confirmed that syphilis takes on an especially malignant form in malarial cachectics (Moursou, Lepers).
We may add, in regard to all these mixed infections, that the diminution of the resisting power of the organism brought about by the malaria makes it especially suitable for the invasion of a second infection. This double infection is usually severe, and much more threatening than when the two infections are separate.
As to the relations of lead poisoning to malaria , Moursou claims that it creates a predisposition to pernicious attacks, like delirium, epilepsy, hemoglobinuria, cardialgia, etc. We have already stated, in another place, that this writer considers " colique seche" as lead intoxication, and denies any connection between it and malaria, though we may add that, with few exceptions, his anamnesis failed to show the presence of saturnism.