Blood sugar during the crisis of malarial fever.

Abstract

In previous papers 1 we have called attention to the fact that a distinct balance exists in the autonomic orientation between the peripheral region of the body and the splanchnic area. Muller 2 has studied the relation of this balance to the distribution of leukocytes, while in our own work with the lymph we have studied the alternations in permeability. In the present series of observations we have studied the changes in the blood sugar during malarial fever (artificial inoculation) with particular reference to the crisis.

In the fasting patient we have determined that the period of the chill and rise in temperature is associated with a decrease in the blood sugar level. This corresponds to the time of a peripheral leukopenia and a diminished concentration of blood protein. With the crisis and fall in temperature, blood sugar increases, leukocytes increase in the peripheral blood stream and the blood proteins increase. These pictures can be regarded as a result of a reversal of the autonomic balance. In the first stage we have a peripheral sympathetic tonus with a splanchnic parasympathetic orientation; in the period of defervescence, a peripheral parasympathetic and splanchnic sympathetic tonus. We cannot, of course, exclude the effect of metabolic utilization of the sugar. We believe, however, that the magnitude of the sugar mobilization during the period of defervescence would indicate a splanchnic sympathetic effect.