202 THOMPSON YATES AND JOHNSTON LABORATORIES REPORT 
China. 
Cochin China. Berenger Feraud, loc. cit., states that blackwater fever is fre- 
quent in Cochin China. Hirsch, loc. cit., Veillard," 9 Disser,' 20 record cases. 
Tonkin. Paucot 122 saw seven cases in two years at Haut-Song-Cau. Five of 
these were among Europeans long in the colony. 
Fontaine 114, says, ' that blackwater tever is rare in the old towns of the Delta, 
but frequent in the high country, particularly at Dong Song.' 
Le Ray" 3 describes it at Cao-Bang. 
Dutch East Indies. 
V. Leent 125 says, ' jusqu'a present le fievre jaune n'a jamais visite l'archipel des 
Indes Orientales. Nous croyons que ce sont des cas de fievre pernicieuse ictero 
hemorrhagic qui ont conduit certains observateurs a admettre a tort l'apparition dans 
ces parages de cas de typhoide icterode.'* 
British Malaya. 
Hamilton Wright 126 describing a case ot ' pernicious fever ' refers to it as 
rare. The case is undoubtedly blackwater tever, and is an accurate picture of that 
disease, though not recognized by the author as such. 
New Guinea (German). 
Sch ellong, 127 Dempwolf 128 describe blackwater as existing here. 
New Hebrides. 
Morel 129 describes a case. It may, however, be an imported one. 
It must be evident from these scanty ones how inadequate are the references 
in literature to give a true idea ot the exact prevalence ot blackwater fever. The 
fact that in India, in the Jeypore agency (Madras), Christophers and myself found that 
practically all the missionaries established there had suffered from blackwater fever ; 
that we had, in tact, a distinct blackwater area there which, at all events, to medical 
men outside the district was completely unknown, shows that caution must be 
exercised in assuming the absence ot blackwater fever in a country unless it has been 
recorded. Nor do I think that the prevalence ot blackwater fever in India is yet 
exhausted. Moreover, there is one fact which must be considered, viz., whether in 
any district we have a susceptible European papulation, and, in considering its relation 
to malaria, above all, differences in virulence of malaria must be taken into account, the 
species of parasite, and other factors, e.g., conditions of life ; thus it is a quite erroneous 
method in comparing the prevalence of blackwater among two European populations, 
*Maurer 1 2 5 A states that there is no blackwater tever in Sumatra although the severest cases of malaria are not uncommon, 
but this is contrailicted by the fact that it is common among the Dutch at Acheen. It also occurs at Java, especially at Tjilatjap 
(Scheube) 163 . 
