Martin states that he never saw thickening of the epididymis remain, though often hydrocele. The majority of other writers report a termination in atrophy of the testicle. Girert observed in Panama, among 350 malaria cases, 192 times orchitis with subsequent atrophy of one or both testicles.

Laveran is very skeptical in regard to malarial orchitis, and asserts that the majority of cases were probably ones of gonorrheal, parotitic, tuberculous, or, in the tropics, filarial orchitis.

We must add that an accurate blood examination for malarial parasites, as well as filaria, together with a careful weighing of other circumstances (gonorrhea, epidemic parotitis, tuberculosis, etc.), is demanded before a diagnosis of malarial orchitis can be made with certainty.

Fayrer frequently observed in India hydrocele as a result of malaria . (For disturbances of the bladder see section on Nervous System.)

Metrorrhagia is not rare during the paroxysms, and in case of pregnancy, may produce abortion.

Malarial Infection And Pregnancy

Pregnancy constitutes no protection against malarial infection, notwithstanding older observations to the contrary. In a gravid woman the infection often takes on a severe form. The influences making for anemia in case of even light infection are more important in the pregnant woman than in others.

Abortion occurs very frequently. A. Weatherley reported at the Medical Congress in Calcutta that in India 46.6 per cent, of his cases aborted, while in England the frequency amounts to not more than about 3.56 per cent. Pellereau reports the same from Mauritius. The abortion does not require a fever paroxysm for its production. The fetus is usually dead before the abortion occurs.

Weatherley also finds sterility very common among the women in India, and he lays this at the door of malaria .

According to Chevers (India), the act of parturition often operates as an exciting cause in an outbreak of malaria , during which the lochiae and milk secretion cease. Recovery occurs in the great majority of cases. The same was reported by Barker in New York. He had only one death among 47 cases (quoted after Roux). Blood examinations would be naturally very desirable in similar cases, since the possibility of septic infection is too great.

According to Emmett (quoted after Roux), subinvolution of the uterus and postpartum hemorrhage may occur.