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numbers; that in numbers he will always exceed the white man, while 
he may some day come to rival him in intelligence ; and that finally if we 
do not use our power to govern him with absolute justice the time will 
come sooner or later when he will rise against us and expel us as the 
Egyptian officials were expelled from the Sudan. 
APPENDIX I. 
BILIOUS HTMOGLOBINURIC : OR, BLACK-WATER FEVER 
BY DR. D. KERR CROSS, M.B. 
This form of fever has been met with in the Mauritius, Senegal, Madagascar, the 
Gold Coast, French Guiana, Venezuela, in some parts of Central America, and the West 
India Islands. It is even said to have been seen in some parts of Italy and Spain. It 
has been carefully studied in Nosi-be, on the north-west of Madagascar, where it is 
estimated that one in fourteen of the Malarial Fevers treated there were Hfemoglobinuric. 
Some cases observed in Rome have been carefully studied, with the result that some are 
associated with the Plasmodium Afalarice —the Bacterium in Malarial Fever—while others 
are not. The same has been the case on the Gold Coast. The generally accepted 
opinion is that Hsemoglobinuric fever may arise apart from any malarial affection. 
Any bacterium which destroys the Red Blood Corpuscles and sets free the red colouring 
matter—Hmmoglobin—will bring about this form of fever. Hiemoglobin is an irritant 
to the kidneys, and brings on a congested state of that organ. In this form of fever we 
always find the kidneys abnormal both in size and in weight, while there is a bleeding into 
the tissue under the capsule and in the interstitial cortical substance, or with the discolora¬ 
tion which we know to result from these conditions. The Epithelia lining the convo¬ 
luted tubes of the kidney are larger than normal and are cloudy, while the tubes 
themselves contain casts that are stained yellow ; this yellow staining being in a very 
fine state of division or, in some cases, in large granules. There is a marked obstruction 
of the tubules of the kidney, both in the cortical and pyramidal portion. The blood 
vessels and capillaries are often found to contain corpuscles that are deeply stained. This 
is also the case with the glomeruli of the organ. The serum of the blood contains great 
quantities of free haemoglobin which gives it a yellow colour. This yellow colour is 
seen in the serum obtained from the application of a blister to the surface and in blood 
drawn for microscopic purposes. 
This form of fever begins as a regular remittent. There is usually severe vomiting of 
bilious matter—indeed, my experience is that in a severe case there is vomiting every 
half-hour night and day. There are bilious stools of a frothy yellow substance. There 
is very marked jaundice over the whole body. There is delirium of a violent form. 
Sometimes there is a free discharge of black urine or, it may be. of actual blood. 
Towards the close of a fatal case there is suppression of the urine resulting in coma and 
convulsions. Everything in this affection points to the wholesale destruction of the 
Red Blood Corpuscles, and to a desperate effort on the part of the system to throw 
something off. From the suddenness with which the tissues of the whole body become 
yellow, we might say that every tissue takes on itself the power of secreting bile. Bile is 
eliminated by the bowels, by the skin, by the kidneys, and by the liver. The patient 
vomits, purges, sweats, and in some cases bleeds. The gums, it may be, become spongy 
and sore, and may even shed blood. There may be bleeding from the mouth and nose 
and over purple spots on the skin. As in the case of yellow fever, there may be a 
