On the issue of a ruptured malarial spleen

Rupture of the spleen is quite frequent in tropical countries, where pathological spleen is a common occurrence, and where this damage is observed often from negligible trauma. Thus Grawford, working in India, collected 477 cases of ruptured spleen there, and of those 387 cases where the weight of this organ was known, only in 18 it was within normal limits. The authors who collected material from non-tropical countries (Krukov, Leverenz, Berger, Finkelstein), usually the cause of ruptures was a very severe trauma - in most cases a healthy spleen.