2 4 I 



Chapter XXIII 



BLACKWATER FEVER 



Diagnosis. Attention should be paid to the 

 following points : 



(1) Haemoglobinuria. The colour of the urine 

 may vary from a very light red to a dark porter colour. 



(2) Jaundice. Varying from a pale lemon yellow 

 to a deep bronze. 



(3) Constitutional Disturbance. Slight, or ex- 

 tremely severe, with a high temperature, vomiting of 

 green bile, sudden anaemia, pain over kidneys and 

 gall bladder, collapse. 



EXAMINATION OF THE BLOOD IN BLACKWATER 

 FEVER 



1. Note the difficulty in obtaining a full-sized 

 drop of blood. 



2. Observe the 4 thin ' nature of the blood drop, 

 its ' oily ' nature, and the difficulty with which it 

 adheres to the slide. These properties are best seen 

 in, severe cases. 



3. Collect a specimen in a fine pipette and 

 allow the serum to separate. Observe whether the 

 serum is yellow (cholaemia) or reddish (haemoglobin- 

 aemia), using the spectroscope if necessary. 



4. To some of patient's serum add ' washed ' (p. 

 225) red cells, (i) of the patient, (2) of a normal 

 person. Observe whether there is any haemolysis, 

 in vitro, or microscopically. 



5. Determine tonicity of patient's blood (p. 225). 

 (a) Vincent and Dopter recently determined 



