198 THOMPSON YATES AND JOHNSTON LABORATORIES REPORT 
3. With regard to the distribution of malaria, Celli 83 says, ' Les parasites 
estivo-autunnales ont un divers degre de virulence et que en general, ils ont une 
virulence plus exaltee dans l'ltalie inferieure, marennesde Toscane, et de Rome, Midi, 
lies. Le nombre proportionnel des morts est beaucoup plus elevee dans l'ltalie 
inferieure.' 
4. Vide above, Schaudinn's observations with regard to the mildness of 
'Tropica' (estivo-autumnal) in Northern Italy and Austria. 
5. The accompanying map shews how markedly malaria varies in intensity 
throughout Italy, and how it reaches its maximum in the extreme South (Calabria), 
in Sicily and Sardinia, in both which places blackwater fever is 'not rare' (vide 1). 
In these two instances, only, have I found it possible to compare the distribu- 
tion of malaria and blackwater fever. In the United States the data shew a close 
correspondence ; in Italy, also, we find that in the regions of really severe malaria, 
blackwater also occurs. Whether or no, the correspondence is as close as I believe 
the facts enable us to conclude, yet the varying intensity of malaria in the States and 
the striking variations in Italy also clearly shew that to speak broadly of malaria as 
a whole in a country is by no means justifiable. 
In the rest of this paper 1 must necessarily be content with pointing out the 
distribution of blackwater, which is, 1 believe, wider than is generally supposed, adding 
only some comments which appear to be of interest, from the sources I have examined. 
Greece. 
Pampoukis and Chomatianos 84 say that quinine hemoglobinuria was first re- 
corded by M. S. Var ettas, Nov. 6, 1858 (Soc. Med. Grecque de Paris). 
Blackwater fever is recorded by Greek physicians in Patras, Albania, Agrinion, 
the military hospital, Athens, Karvassara, Thessaly, Salonika, etc. 
It is interesting to note that according to Karamitsas, 8 ' in Athens, malarial 
diseases have a very slight intensity, and are only seldom pernicious. With regard 
also to blackwater, Karamitsas 87 savs, that no case of the disposition to blackwater 
is acquired in Athens. 
Turkey. 
Karamitsas records a case in a small village in Turkey. But here, as in so 
many other instances, it is impossible to form any idea of its real prevalence. 
Russia (Merv). 
Gekow 95 investigated exactly, cases of blackwater fever that frequently occurred 
there. He takes the malaria and quinine view. 
Palestine. 
Cropper 94 records blackwater fever in three districts. In Khudeirah, he says 
the natives suffer much less from malaria than the Jews, and hardly at all from 
