2 4 x 
Chapter XXIII 
Blackwater Fever 
Diagnosis. —Attention should be paid to the 
following points :—- 
(1) Haemoglobinuria. —The colour of the urine 
may vary from a very light red to a dark porter colour. 
(2) Jaundice. —Varying from a pale lemon yellow 
to a deep bronze. 
(3) Constitutional Disturbance. — Slight, or ex¬ 
tremely severe, with a high temperature, vomiting of 
green bile, sudden anaemia, pain over kidneys and 
gall bladder, collapse. 
Examination of the Blood in Blackwater 
Fever 
1. Note the difficulty in obtaining a full-sized 
drop of blood. 
2. Observe the 4 thin ’ nature of the blood drop, 
its £ oily 5 nature, and the difficulty with which it 
adheres to the slide. These properties are best seen 
in severe cases. 
3. Collect a specimen in a fine pipette and 
allow the serum to separate. Observe whether the 
serum is yellow (cholaemia) or reddish (haemoglobin- 
aemia), using the spectroscope if necessary. 
4. To some of patient’s serum add £ washed ’ (p. 
225) red cells, (1) of the patient, (2) of a normal 
person. Observe whether there is any haemolysis, 
in vitro , or microscopically. 
5. Determine tonicity of patient’s blood (p. 225). 
(a) Vincent and Dopter recently determined 
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