245 



UROBILINURIA 



As we have indicated elsewhere, the occurrence 

 of urobilin may be an important indication in cases 

 where a susceptibility to quinine haemoglobinuria 

 exists : thus, in Murri's case, a girl had haemoglo- 

 binuria eight times between August 3, 1894, and April 

 6, 1895, following upon the administration eight times 

 of small doses of quinine. From 1895 to 1897, the 

 girl remained well. On March 27, 1897, she was 

 given 0*5 gramme of quinine, to see whether her 

 disposition to quinine poisoning still remained. The 

 result was fever, vomiting of bile, etc., albuminuria, 

 peptonuria, and urobilinuria (not haemoglobinuria). 



A. Plehn, in a recent paper, points out a peculiar 

 property of the urine sometimes observed in blackwater 

 cases. On boiling the urine and allowing to stand for 

 some time, a bright purple colour appears. 



We have observed that blackwater urines made 

 alkaline with potash, and then boiled produce a purple 

 colour, giving the bands of haemochromogen (reduced 

 haematin), shewing that the urine itself contained 

 reducing bodies. 



Whether Plehn's purple colour is the same we 

 cannot say. 



POST-MORTEM EXAMINATION 



1. Make smear preparations of spleen, kidney, 

 liver, bone marrow, brain, etc. Examine for parasites 

 and pigmented leucocytes. Parasites are generally 

 absent, but pigmented leucocytes may occur in large 

 numbers in the spleen. Fine pigment is also found in 

 the liver in endothelial capillary cells. (Fig 13). 



2. Cut sections, especially of brain tissue, as 

 parasites may be found in the capillaries and nowhere 

 else. 



