2 4 2 



the isotonic point of the blood of a patient suffering 

 from chronic malaria, and who had had no blackwater 

 for a month, and found it to be 0*44 per cent. NaCl, 

 i.e., its resistance was less than normal. 



(b) One hour after taking quinine, at the 

 beginning of the actual haemoglobinuria, the 

 resistance had fallen, i.e., the isotonic point had gone 

 up to 0*46 per cent. 



(c) Four hours after the haemoglobinuria, the 

 resistance had increased up to 0*41 to 0*42 per cent. 



(d) Nine days after the haemoglobinuria it had 

 reached the normal. 



Haemolytic Action of Quinine. (i) The amount 

 of quinine hydrochloride (neutral) sufficient to haemo- 

 lyse I c.c. of an emulsion of washed red cells at 37 C., 

 in vitro, was 0*001 to 0*00082 gramme in a healthy 

 patient. (2) On the contrary, in the blackwater 

 patient, it was less, viz. : 0*0008 to 0*00062, or even 

 during an attack, 0*0005. 



Action of Calcium Chloride. The blood in the 

 above case, with an isotonic point of 0*46, was exposed 

 to the action of calcium chloride (one drop of a ten 

 per cent, solution, to 3 c.c. of the blood cell emulsion). 

 The corpuscles were then washed in 0*075 per cent, 

 salt solution once. The isotonic point was now 

 found to be lower, viz. : 0*41, i.e., the resistance to 

 haemolytic agents was raised. 



6. Count the red and white cells. The red cells 

 are, as a rule, quite normal in shape. 



7. Determine the amount of haemoglobin. 



8. Make films every two hours if possible (as 

 early as possible), noting accurately the time and 

 temperature at which the films are made. 



9. Examine films for parasites ; if these are 

 absent, search carefully several large films for pigmented 



