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CHAPTER VII. 

 BLACKWATER FEVER. 



THROUGHOUT Tropical Africa, haemoglobinuric fever, 

 or blackwater fever, is one of the most important of the 

 diseases met with and an important cause of the ex- 

 cessive mortality amongst Europeans. In the numerous 

 enquiries made into the causation of this disease by various 

 observers the possibility of the active causal agent being 

 a piroplasma, or other specific organism, has been fully 

 considered. No piroplasmata have been found, and as 

 competent observers have made the examinations, if it 

 is due to such a parasite it must be to one so small that 

 it has escaped detection. Various observers have found 

 other organisms, but in most instances the bodies 

 described are not admitted to be specific organisms. 

 The distribution of the African Ixodidae does not support 

 the hypothesis that it is a disease carried by ticks, as it 

 probably would be if it were a piroplasmosis. 



Blackwater Fever (Endemic Haemoglobinuria). This 

 disease is essentially an acute haemolysis, usually of short 

 duration, terminating in recovery, unless complications, 

 such as suppression of urine, occur. Death also occurs 

 from the intensity of the anaemia induced, and more 

 rarely from hyperpyrexia. The causation is not definitely 

 known. 



Geographical Distribution. It is a common disease 

 throughout the whole of tropical Africa and occurs in 

 subtropical South Africa. It occurs frequently in Assam 

 and some of the Indian terais ; isolated cases occur in 

 South America, and it is common in Panama ; in Malay 

 it is now fairly common, and in the islands in the Indian 



