EXPERIMENTAL MALARIA IN MAN. II. LIVER FUNCTION 1

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Abstract
Tertian malaria was produced in 12 young men, previously normal, by inoculation with the McCoy strain of Plasmodium vivax. and was terminated with quinine after 5-8 paroxysms. Prompt and delayed reacting plasma bilirubin rose, respectively, from mean control values of 0.069 and 0.76 mg. per 100 cc. to 0.19 and 1.39 in the first paroxysms of fever, and to means of 0.20 and 1.60 in paroxysms 4 through 7. Bilirubinuria did not occur. Urobilinogen excretion rose progressively from a control avg. of 1.16 Ehrlich units in 2-hr. collections to a mean of 2.73 units in the 1st febrile stages and a mean of 5.59 units for fever paroxysms 4 through 7. Both plasma bilirubin and urobilinogen excretion returned to normal within a week from the start of quinine. Bromsulfalein retention (45 min.) averaged 8.9% in the early febrile stages and 11.3% for paroxysms 4 through 7. Normal values were regained in a very few days after quinine. Thymol turbidity values consistently rose in malaria but did not surpass upper "normal" values. Cephalin-cholesterol flocculation values became progressively abnormal after several febrile paroxysms and, in most cases, were highest in the first weeks following quinine. In malaria the liver had a load of about 4 times the normal amount of degraded hemoglobin to dispose of and it was concluded that the plasma bilirubin values found here represented only a moderate degree of actual impairment of the liver. There was a good correlation in malaria between cephalin flocculation results and the percentage of the serum protein represented by gamma globulin. None of the test results showed a significant correlation with either the actual body temp. at the moment or the total fever (degree-hours).
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