G. A. Turner 
203 
a patient, a young Pondo, who told me he first noticed that he was 
passing blood in his urine after a fall from a horse. 
In some cases, though the urine appears quite clear, if it is treated 
in a centrifuge, and then examined under a microscope, red blood 
corpuscles and a few ova will be found. At other times, the whole 
urine passed is faintly blood-stained, or the first water evacuated may 
be quite clear, a few drops of pure blood only appearing at the end of 
micturition. With some cases, small tube-shaped blood clots are passed 
in the urine stream. In the most severe cases, almost pure blood is 
emitted and occasionally this may coagulate in the bladder so firmly as 
to cause complete suppression of urine. I have only seen the last 
condition once; it was a case of a European who came from the 
Rustenburg district. 
With severe haematuria cystitis often develops, thus necessitating 
frequent micturition, which, with the anaemia and the mental worry, 
has a very debilitating effect on the system. I must, however, admit 
that I have never had a native or European die of uncomplicated 
Bilharzia disease of the bladder, though I have seen some excessively 
severe haemorrhages as a result of it. 
The haematuria is frequently brought on by violent exertion, 
especially riding. 
On several occasions, I have had patients admitted to hospital who 
rolled on the floor in intense pain, which they referred to the pubic 
region; they had apparently no other symptom, though one native had 
incontinence of urine. With a catheter a small amount of purulent 
urine, containing Bilharzia ova, was drawn off. When I first saw 
these patients I thought they had received an irritating poison, and 
that possibly some native doctor had been administering a mixture 
somewhat more searching in its effects even than those they usually 
employ. However, hot fomentations, hypodermic injections of morphia 
and urotropine administered by the mouth, relieved the symptoms, and 
after a few days the patients recovered sufficiently to be transferred to 
the convalescent room. They remained fairly well there for a week or 
two. After this time, they were readmitted to hospital with indefinite 
symptoms and often died suddenly within a few days. At other times, 
these patients lay wrapped in their blankets in a drowsy condition for 
days and weeks. Beyond the fact that their urine contained albumen, 
which is so common an occurrence among native patients, that one has 
to disregard its presence, there were no symptoms indicating the cause 
of the condition. The temperature on admission usually being above 
