Malarial Pigment (hematin) as a Factor in the Production of the Malarial Paroxysm

The paroxysm of hematin intoxication in the rabbit undoubtedly presents many features of striking similarity to the paroxysm of human malaria; still one must hesitate to apply such results unreservedly in an attempt to identify the causative agent of the malarial paroxysm. When, in addition to the character of the paroxysm, we consider the sequence of events in the two instances, the analogy becomes so close that it seems impossible to regard the matter as a mere coincidence. The injection of hematin, especially in fractional doses, is in a measure comparable to the liberation of hematin into the human circulation by the malarial parasite. In these experiments, See PDF for Structure both solution and finely divided suspensions of hematin have been found equally effective in eliciting the phenomena of the paroxysm, and while it seems possible that a portion of the malarial pigment might be dissolved in the alkaline human serum, such an assumption is probably not essential. It might be objected that the toxic action of foreign hematin thus injected into the circulation would probably be greater than that of hematin derived from an animal's own blood, but as far as I have been able to determine, this objection does not seem valid, as rabbit hematin, dog hematin, and ox hematin produce in the rabbit effects that are alike in both character and degree. The dose of hematin remains as the one factor to which it is possible to attach some degree of uncertainty, but even here the author feels that the range of experimental conditions has been kept within the bounds of legitimate analogy with conditions existing in the human subject of malarial infection. Finally, the most conservative estimate of the value of such experiments points strongly to the fact that we have at least a potentially toxic substance in the pigment hematin as liberated by the malarial parasite into the circulation of the human host. There is also abundant evidence to show that the action of hematin is not confined to the paroxysmal phenomena of malaria, but that other features of the disease may find their explanation in the action of this pigment. For the present, however, it seems advisable to confine the discussion to this one phase of the question.