MALARIA

Dictionary Meaning -

(according to Dorland's pocket medical Dictionary)

An Infectious Febrile Disease Endemic In Many Warm Regions Of The World, Caused By Protozoa Of The Genus Plasmodium, Which Are Parasitic In Red Blood Cells; It Is Transmitted By Anopheles Mosquitoes And Marked By Attacks Of Chills, Fever, And Sweating Occurring At Intervals That Depend On The Time Required For Development Of A New Generation Of Parasites In The Body.

Falciparum Malaria - The Most Serious Form, Due To Plasmodium Falciparum, With Severe Constitutional Symptoms And Sometimes Causing Death.

Ovale Malaria - A Mild Form Due To Plasmodium Ovale, With Recurring Tertian Febrile Paroxysms And A Tendency To End In Spontaneous Recovery.

Quartan Malaria - That In Which The Febrile Paroxysms Occur Every 72 Hours, Or Every Fourth Day Counting The Day Of Occurrence As The First Day Of Each Cycle; Due To Plasmodium Malariae.

Quotidian Malaria - Vivax Malaria In Which The Febrile Paroxysms Occur Daily.

Tertian Malaria - Vivax Malaria In Which The Febrile Paroxysms Occur Every 42 To 47 Hours, Or Every Third Day Counting The Day Of Occurrence As The First Day Of The Cycle.

Vivax Malaria - That Due To Plasmodium Vivax, In Which The Febrile Paroxysms Commonly Occur Every Other Day ( Tertian Malaria ), But May Occur Daily ( Quotidian Malaria ), If There Are Two Broods Of Parasites Segmenting On Alternate Days.


Pathological Point Of View -

• Malaria Is A Mosquito-Borne Infectious Disease Of Humans And Other Animals Caused By Parasitic Protozoans (A Type Of Unicellular Microorganism) Of The Genus Plasmodium. 

• Commonly, The Disease Is Transmitted By A Bite From An Infected Female Anopheles Mosquito, Which Introduces The Organisms From Its Saliva Into A Person's Circulatory System. 

• In The Blood, The Parasites Travel To The Liver To Mature And Reproduce. 

• Malaria Causes Symptoms That Typically Include Fever And Headache, Which In Severe Cases Can Progress To Coma Or Death.

Signs & Symptoms :-

• The Signs And Symptoms Of Malaria Typically Begin 8–25 Days Following Infection. 

• However, Symptoms May Occur Later In Those Who Have Taken Antimalarial Medications As Prevention.

Initial Manifestations Of The Disease -

• Common To All Malaria Species - Are Similar To Flu-Like Symptoms, And Can Resemble Other Conditions Such As Septicemia, Gastroenteritis, And Viral diseases. 

• The Presentation May Include Headache, Fever, Shivering, Joint Pain, Vomiting, Hemolytic Anemia, Jaundice, Hemoglobin In The Urine, Retinal Damage, And Convulsions.

The classic symptom of malaria is paroxysm -

• A Cyclical Occurrence Of Sudden Coldness Followed By Shivering And Then Fever And Sweating, Occurring Every Two Days ( Tertian Fever ) In P. Vivax And P. Ovale Infections, And Every Three Days ( Quartan Fever ) For P. Malariae. And P. Falciparum Infection Can Cause Recurrent Fever Every 36–48 Hours Or A Less Pronounced And Almost Continuous Fever.

Severe Malaria Is Usually Caused By P. Falciparum (Often Referred To As Falciparum Malaria).

• Symptoms Of Falciparum Malaria Arise 9–30 Days After infection. 

• Individuals With Cerebral Malaria Frequently Exhibit Neurological Symptoms, Including Abnormal Posturing, Nystagmus, Conjugate Gaze Palsy ( Failure Of The Eyes To Turn Together In The Same Direction ), Opisthotonus, Seizures, Or Coma.

Recurrence -

• Symptoms Of Malaria Can Recur After Varying Symptom-Free Periods. 

• Depending Upon The Cause, Recurrence Can Be Classified As Either Recrudescence, Relapse, Or Reinfection. 

• Recrudescence Is When Symptoms Return After A Symptom-Free Period. It Is Caused By Parasites Surviving In The Blood As A Result Of Inadequate Or Ineffective Treatment. 

• Relapse Is When Symptoms Reappear After The Parasites Have Been Eliminated From Blood But Persist As Dormant Hypnozoites In Liver Cells. Relapse Commonly Occurs Between 8–24 Weeks And Is Commonly Seen With P. Vivax And P. Ovale Infections. 

• Reinfection Means The Parasite That Caused The Past Infection Was Eliminated From The Body But A New Parasite Was Introduced. Reinfection Cannot Readily Be Distinguished From Recrudescence, Although Recurrence Of Infection Within Two Weeks Of Treatment For The Initial Infection Is Typically Attributed To Treatment Failure. 

• People May Develop Some Immunity When Exposed To Frequent Infections.

Cause :-

• Malaria Parasites Belong To The Genus Plasmodium ( Phylum Apicomplexa ). 

• In Humans, Malaria Is Caused By P. Falciparum, P. Malariae, P. Ovale, P. Vivax And P. Knowlesi; Among Those Infected, P. Falciparum Is The Most Common Species Identified (~75%) Followed By P. Vivax (~20%). Although P. Falciparum Traditionally Accounts For The Majority Of Deaths.

• Climate Change Is Likely To Affect Malaria Transmission, But The Severity And Geographic Distribution Of Such Effects Is Currently Uncertain.

Life Cycle :-

Pathophysiology :-

• Malaria Infection Develops Via Two Phases: 

• One That Involves The Liver ( Exoerythrocytic Phase ), And 

• Another That Involves Red Blood Cells, Or Erythrocytes ( Erythrocytic Phase ). 

• When An Infected Mosquito Pierces A Person's Skin To Take A Blood Meal, Sporozoites In The Mosquito's Saliva Enter The Bloodstream And Migrate To The Liver Where They Infect Hepatocytes, Multiplying Asexually And Asymptomatically For A Period Of 8–30 Days.

• After A Potential Dormant Period In The Liver, These Organisms Differentiate To Yield Thousands Of Merozoites, Which, Following Rupture Of Their Host Cells, Escape Into The Blood And Infect Red Blood Cells To Begin The Erythrocytic Stage Of The Life Cycle.

• The Parasite Escapes From The Liver Undetected By Wrapping Itself In The Cell Membrane Of The Infected Host Liver Cell.

• Within The Red Blood Cells, The Parasites Multiply Further, Again Asexually, Periodically Breaking Out Of Their Host Cells To Invade Fresh Red Blood Cells. 

• Several Such Amplification Cycles Occur. 

• Thus, Classical Descriptions Of Waves Of Fever Arise From Simultaneous Waves Of Merozoites Escaping And Infecting Red Blood Cells.

Some P. Vivax Sporozoites Do Not Immediately Develop Into Exoerythrocytic-Phase Merozoites, But Instead Produce Hypnozoites That Remain Dormant For Periods Ranging From Several Months (7–10 Months Is Typical) To Several Years. 

After A Period Of Dormancy, They Reactivate And Produce Merozoites. 

Hypnozoites Are Responsible For Long Incubation And Late Relapses In P. Vivax Infections, Although Their Existence In P. Ovale Is Uncertain.

• The Parasite Is Relatively Protected From Attack By The Body's Immune System Because For Most Of Its Human Life Cycle As It Resides Within The Liver And Blood Cells And Is Relatively Invisible To Immune Surveillance. 

• However, Circulating Infected Blood Cells Are Destroyed In The Spleen. 

• To Avoid This Fate, The P. Falciparum Parasite Displays Adhesive Proteins On The Surface Of The Infected Blood Cells, Causing The Blood Cells To Stick To The Walls Of Small Blood Vessels, Thereby Sequestering The Parasite From Passage Through The General Circulation And The Spleen. 

• The Blockage Of The Microvasculature Causes Symptoms Such As In Placental Malaria. 

• Sequestered Red Blood Cells Can Breach The Blood–Brain Barrier And Cause Cerebral Malaria.

Classification :-

Malaria Is Classified Into Either "Severe" Or "Uncomplicated" By The World Health Organization (WHO). It Is Deemed Severe When Any Of The Following Criteria Are Present, Otherwise It Is Considered Uncomplicated.

• Decreased Consciousness
• Significant Weakness Such That The Person Is Unable To Walk
• Inability To Feed
• Two Or More Convulsions
• Low Blood Pressure ( Less Than 70 mmHg In Adults And 50 mmHg In Children )
• Breathing Problems
• Circulatory Shock
• Kidney Failure Or Hemoglobin In The Urine
• Bleeding Problems, Or Hemoglobin Less Than 50 g/L (5 g/dL)
• Pulmonary Oedema
• Blood Glucose Less Than 2.2 mmol/L (40 mg/dL)
• Acidosis Or Lactate Levels Of Greater Than 5 mmol/L
• A Parasite Level In The Blood Of Greater Than 100,000 Per microlitre (µL) In Low-Intensity Transmission Areas, Or 250,000 Per µL In High-Intensity Transmission Areas

Cerebral Malaria Is Defined As A Severe P. Falciparum-Malaria Presenting With Neurological Symptoms, Including Coma ( With A Glasgow Coma Scale Less Than 11, Or A Blantyre Coma Scalegreater Than 3 ), Or With A Coma That Lasts Longer Than 30 Minutes After A Seizure.

Complications :-

• Severe Anaemia

• Respiratory Distress

• Metabolic Acidosis

• Noncardiogenic Pulmonary Oedema

• Concomitant Pneumonia

Management :-

Prevention :-

• Methods Used To Prevent Malaria Include Medications, Mosquito Elimination And The Prevention Of Bites. 

• There Is No Vaccine For Malaria.

Man Spraying Kerosene Oil In 

Standing Water, Panama Canal 

Zone 1912

Walls Where Indoor Residual Spraying Of DDT Has Been Applied. The Mosquitoes Remain On The Wall Until They Fall Down Dead On The Floor.

Mosquito Nets Create A Protective Barrier Against Malaria-Carrying Mosquitoes That Bite At Night.

 Diagnosis :-

• Owing To The Non-Specific Nature Of The Presentation Of Symptoms, Diagnosis Of Malaria In Non-Endemic Areas Requires A High Degree Of Suspicion, Which Might Be Elicited By Any Of The Following : 

• Recent Travel History 

• Enlarged Spleen 

• Fever 

• Low Number Of Platelets In The Blood And 

• Higher-Than-Normal Levels Of Bilirubin In The Blood Combined With A Normal Level Of White Blood Cells.

• Malaria Is Usually Confirmed By The Microscopic Examination Of Blood Films Or By Antigen-Based Rapid Diagnostic Tests (RDT). 

The Blood Film Is The Gold Standard For Malaria Diagnosis.

Ring-Forms And Gametocytes Of Plasmodium Falciparum In Human Blood

 For More Details :-

• http://en.wikipedia.org/wiki/Malaria 

Allopathic Treatment :-

• Chloroquine May Be Used Where The Parasite Is Still Sensitive.

• As Most Plasmodium Is Resistant To One Or More Medications, One Of Three Medications -

• Mefloquine ( Lariam ) 

• Doxycycline ( Available Generically ) Or 

• Combination Of Atovaquone And Proguanil Hydrochloride ( Malarone ) Is Frequently Needed. ( Doxycycline And The Atovaquone And Proguanil Combination Are The Best Tolerated; Mefloquine Is Associated With Death, Suicide, And Neurological And Psychiatric symptoms. )

Homoeopathic Treatment :-

" One Single Simple Drug Substance In Its Most Suitable Potency, According To Symptom Similarity Based On Totality! "

In Case Of Malaria, List Of Useful Remedies (According To REPERTORY

by Oscar E. BOERICKE, M.D.) Are As Below-

INTERMITTENT FEVER (ague, malarial) -- Acon., Alston., Am. m., Am. picr., Amyl, Ant. c., Ant. t., Apis, Aran., Arn., Ars., Ars. br., Azadir., Baja, Bapt., Bell., Bolet., Bry., Cact.,Camph. monobr., Canchal., Caps., Carb. ac., Carbo v., Ceanoth., Ced., Centaur., Chin. ars., Chin. mur., Chin. s., Chionanth., Cimex, Cina, Cinch., Corn. fl., Crot., Echin., Elat., Eucal., Eup. perf., Eup. purp., Ferr. m., Ferr. p., Gels., Helianth., Hep., Hydr., Ign., Ipec., Lach., Laur., Lyc., Malland., Menyanth., Methyl. bl., Nat. m., Nat. s., Nitrum, Nux v., Op., Ostrya, Pambot., Parth., Petros., Phell., Phos. ac., Pod., Polyp., Puls., Rhus t., Sabad., Spig., Sul., Tarax., Tela ar., Thuya, Urt., Verb., Ver. a., Ver. v.

TYPE

Abuse of quinine, cachexia -- Am. m., Aran., Arn., Ars., Ars. iod., Calc. ars., Carbo v., Ceanoth., Chelone, Chin. ars., Eucal., Eup. perf., Ferr. m., Hydr., Ipec., Lach., Malar. off., Malland., Nat. m., Polymia, Puls., Sul., Ver. a.
Chronic, inveterate cases (See Abuse of Quinine.) -- Abies n., Am. m., Aran., Ars., Ars. br., Calc. ars., Canchal., Carbo v., Corn. c., Corn. fl., Helianth., Ign., Nat. m., Puls., Pyr., Querc., Tela ar.
Congestive -- Camph., Op., Ver. a.Dumb ague -- Ars., Ced., Chelone, Chin. s., Gels., Ipec., Malland., Nux v.Impure cases, in non-malarial regions -- Ipec., Nux v.
Nervo-hysteriacal persons -- Aran., Cocc., Ign., Tar. h.
Pernicious cases -- Ars., Camph., Chin. hydrobr., Chin. s., Crot., Ver. a.Recent cases -- Acon., Aran., Ars., Chin. s., Cinch., Ipec., Tar. h,
Stages, partial, irregular -- Aran., Ars., Cact., Carbo v., Eup. perf., Eup. purp., Ipec., Nat. m.
Stages, regular, well defined -- Chin. s., Cinch.

CHILL

OCCURRENCE TYPE

Afternoon

1 P.M. daily -- Ferr. p.
2 P.M. -- Calc. c., Lach.
3 P.M. -- Apis, Chin. s.
3 - 4 P.M. -- Lyc., Thuya.
4 - 8 P.M. -- Lyc.
4 P.M. -- Æsc.
5 P.M. -- Cinch.

Afternoon late, evening, night -- Aran., Bolet., Ced., Ipec., Petrol., Tar. h.
Anticipating -- Chin. s., Cinch., Nux v.
Forenoon -- Cinch., Formal., Nux v.
Hebdomadal -- Cinch.
Midday -- Gels.
Midnight -- Ars., Nux v.
Mingled, with heat (See Chilliness.) -- Ant. t., Apis., Ars., Cinch., Nux v., Tar. h., Ver. a.
Morning -- Chin. s.

1 - 2 A.M. -- Ars
3 A.M. -- Thuya
4 A.M. -- Ferr. m.
5 A.M. -- Cinch.
6 - 7 A.M. -- Pod.
7 - 9 A.M.; at noon following day -- Eup. perf.
9 - 11 A.M. -- Bapt., Bolet., Mag. s., Nat. m., Wyeth.
11 A.M. and 11 P.M. -- Cact.

Periodical -- Aran., Ars., Bolet., Cact., Ced., Chin. s., Cina, Cinch., Eucal., Ipec.

Every 7 or 14 days; never at night -- Cinch.
Every spring -- Carbo v., Lach., Sul.

Prolonged -- Aran., Bolet., Cact., Canchal., Caps., Chin. s., Eup. purp., Ipec., Menyanth., Nat. m., Nux v., Plumb., Pod., Puls., Pyr., Sabad., Ver. a., Ver. v.
Quartan -- Baja, Chin. s., Cinch., Helleb.
Quotidian -- Ars., Bolet., Chin. s., Ign., Lob. infl., Nitrum, Nux v., Plumb., Tar. h.
Slight -- Ars., Azar., Carbo v., Cina, Cinch., Eup. perf., Eup. purp., Ipec.Tertian -- Calc. c., Chin. s., Cinch., Ipec., Lyc.

LOCATION

Abdomen -- Apis, Calc. c., Menyanth.
Back -- Apis, Bolet., Conv., Dulc., Eup. perf., Eup. purp., Gels., Lach., Mag. s., Nat. m., Pyr.

Between scapulæ -- Am. m., Caps., Pyr., Sep.
Dorsal region -- Eup. perf., Lach.
Lumbar region -- Eup. perf., Nat. m.

Breast -- Cinch.
Feet -- Gels., Lach., Nat. m., Sabad.
Hand, left -- Carbo v., Nux m.
Nose, tip of -- Menyanth.
Thigh -- Rhus t., Thuya.

CONCOMITANTS

Anxiety

Exhaustion, hypochondriacal ideas, mental confusion, vertigo, tension of stomach, no relief from warmth -- Nux v.
Palpitation, nausea, canine hunger, pressing pain in hypogastrium, congestive headache, distended painful veins -- Chin. s., Cinch.

Blue lips, nails -- Eup. perf., Eup. purp., Menyanth., Nat. m., Nux v., Ver. a.
Cardiac region, pain in -- Cact., Tar. h.
Collapsic symptoms; skin icy cold; pallor, cold sweat on forehead -- Ver. a.
Cough, dry, teasing -- Rhus t.
Diarrhœa -- Caps., Elat., Ver. a.
Face and hands bloated -- Lyc.
Face red -- Ferr. m., Ign., Nux v.
Forehead, cold sweat on -- Ipec., Ver. a.
Gastric symptoms -- Ant. c., Arg. n., Ars., Bolet., Canchal., Eup. perf., Ipec., Lyc., Nux v., Puls.
Hands, feel dead -- Apis, Nux v.
Headache -- Bolet., Chin. s., Cinch., Conv., Eup. perf., Eup. purp., Nat. m., Nux v.

Vertigo, yawning, stretching, general discomfort -- Ars.

Heart symptoms, enterrhagia -- Cact.
Hæmorrhoidal symptoms -- Caps.
Hyperesthesia -- Ign.

Spine -- Chin. s.

Loquacity -- Pod.
Nausea before chill -- Ipec.
No two chills alike -- Puls.
Pain

Bones, limbs, soreness [in] -- Aran., Bolet., Canchal., Caps., Chin. s., Cinch., Eup. perf., Eup. purp., Formal., Gels., Nat. m., Nux v., Phell.
Joints [in] -- Cinch.
Knees, ankles, wrists, hypogastrium [in] -- Pod.

Restlessness -- Ars., Eup. perf., Rhus t.
Sighing -- Ign.
Thirst -- Apis, Ars., Caps., Carbo v., Cina, Cinch., Conv., Dulc., Eup. perf., Ign., Nat. m., Nux v., Nyctanth., Ver. a., Wyeth.

Chill [after] -- Ars.
Chill [ before] -- Chin. s., Cinch., Eup. perf., Gels., Menyanth., Nyc. tanth.
Thirstlessness -- Chin. s., Cimex, Cinch., Eup. purp., Gels., Nat. m.

Vehemence, rage, preceding -- Cimex.
Vomiting, bilious -- Eup. perf., Ipec., Lyc., Nat. m., Nux v., Nyxtanth.
Yawning

Somnolency, accelerated breathing -- Nat. m.
Stretching -- Ars., Elat., Lyc., Nux v.

MODALITIES

Aggravation

Acids [from] -- Lach.
Drink [from] -- Caps.
Exposure [from] -- Nux v.
Exposure, lying down [from] -- Cimex.
Motion [from] -- Apis.
Warmth [from] -- Apis, Canchal., Chin. s., Cinch., Nux v.

Amelioration

Warmth [from] -- Caps., Ign.

FEVER PAROXYSM

Afternoon, glowing heat, in face, hands, feet -- Azadin.
Anxiety, restlessness, lipothymia, oppression -- Ars.
Backache -- Eup. perf., Nat. m.
Chill, intermingled -- Ars., Chin. s., Cinch., Nux v., Tar. h.
Chilliness, after heat of face -- Calc. c.
Congestion of head, drowsiness, costiveness, rectal and vesical tenesmus; chilled from uncovering -- Nux v.
Delirium -- Ars., Pod., Sabad.
Desire

to be covered -- Nux v.
to be uncovered -- Ign., Ipec.

Diarrhœa -- Ant. c., Ipec., Ver. a.
Dyspnea -- Apis, Ars., Conv., Ipec.
Face

Face, hot, feet cold -- Cinch., Petrol.
Face, pale, insomnia -- Ant. t.

Gastric symptoms -- Ars., Eup. perf., Ipec., Nux v., Puls.
Hands warm, face cold -- Cina.
Headache -- Apis, Ars., Bell., Ced., Cinch., Eup. perf., Nat. m., Nux v., Wyeth.

Yellowish tongue, nausea, faintness in epigastrium, costiveness -- Polyp.

Heat, burning -- Apis, Ars., Caps., Eup. perf., Formal., Ipec., Lach., Nux v.Hunger -- Cina, Cinch.
Hydroa -- Hep., Nat. m., Rhus t.
Lachrymation -- Sabad.
Loquacity -- Pod.
Mental confusion -- Formal.
Nettle rash -- Apis., Ign., Rhus t.
Night -- Ars.
Pain

Colicky -- Cina.
Head, back, limbs [in] -- Nux v.
The vertebræ, dorsal [in] -- Chin. s.
Spasms, paralysis -- Ars.

Paroxysms, frequent, transient -- Carbo v.
Prolonged heat -- Ars., Bolet., Ign.
Prostration, fainting, cold sweat -- Ver. a.
Pupils, immobile, pain in abdomen, sopor, tension throughout body -- Op.
Sighing -- Ign.
Sleepiness -- Ant. t., Apis, Corn. fl., Gels., Op.
Thirst -- Ars., Chin. s., Cinch., Eup. perf., Nat. m., Nux v., Nyxtanth., Op., Ver. a.

Thirstlessness -- Apis, Caps., Chin. s., Cimex, Cinch., Ign., Nat. m., Puls., Sabad., Wyeth.

Tongue clean -- Ars., Cina.
Trembling of limbs, slow pulse -- Chin. s., Op.
Unconsciousness -- Nat. m.
Vomiting -- Ars., Cim., Cina, Eup. perf., Ipec., Ver. a.
Sweat (See Sweat.) -- Ant. c., Aran., Azadir., Bolet., Bry., Chin. s., Cimex., Cina, Cinch., Conv., Eup. perf., Lyc., Nat. m., Nux v., Op., Phos. ac., Ver. a., Wyeth.

Scanty or absent -- Apis, Ars., Carbo v., Eup. perf., Nux v.
Coldness [with] -- Plumb.
Covering up [with] -- Cinch., Hep.
Relief of pains [with] -- Nat. m.
Sleep [with] -- Cinch., Con., Pod., Thuya.
Thirst [with] -- Ars., Chin. s., Nux v.

APYREXIA

Adynamia

Astro-intestinal pains, sallow face, dropsical swellings, enlarged liver and spleen, restlessness, sleeplessness, spasms, diarrhœa, alburinaria -- Ars.
Hydremia, chlorosis -- Cinch., Puls.
Morning headache, depression, costiveness, amenorrhœa, enlarged liver, desire for quiet, sallow face -- Nat. m.

Gastro-enteric symptoms -- Cinch., Hydr., Ipec., Nux v., Puls.
Jaundice -- Ars., Bolet., Card. m., Nux v., Pod.
Nervous symptoms -- Gels.
Pains -- Led.
Relapses from dietetic errors -- Ipec.
Spleen enlarged -- Ars., Ceanoth., Chin. s., Cinch., Ferr. m., Nat. m.
Thirst -- Ars., Cimex, Ign.
Vomiting -- Ipec.

Abdominal griping, pain in back, loins -- Ver. a.

  For Detail Study Of Above Mentioned Individual Remedy From HOMŒOPATHIC MATERIA MEDICA by William BOERICKE, M.D.:-

•  http://www.homeoint.org/books/boericmm/

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