IV.  MECHANISM  OF  PRODUCTION  OF  SUPPRESSION  OF 
URINE  IN  BLACKWATER  FEVER. 
With  a  view  of  throwing  light  upon  the  mechanism  of  production 
of  blackwater  fever,  tlie  action  of  quinine  on  red  cells,  the  relation 
between  haemolysinaemia  and  blackwater,  and  that  e.xisting 
between  haemoglobinaemia  and  haemoglobinuria,  have  been  studied 
in  the  preceding  sections,  before  proceeding  to  consider  (in  the  next 
section)  how  far  the  data  obtained  m  the  last  section  are  capable  of 
accounting  for  the  haemoglobinuria  of  blackwater  fever,  it  will  be 
convenient  to  deal,  first  of  all,  wdth  a  not  uncommon  sequel  of  black¬ 
water,  namely,  suppression  of  urine,  since  it  may  readily  be  surmised 
that  the  mechanism  of  production  of  this  condition  is  closely  linked 
up  with  that  of  the  haemoglobinuria  of  blackwater  fever.  The 
investigation  of  the  mechanism  of  suppression  of  urine  in  blackwater 
fever  is  in  its  turn  intimately  associated  with  the  study  of  another 
phenomenon  not  hitherto  referred  to,  that  is  the  occurrence  of  casts 
in  the  urine.  In  the  cases  of  blackwater  fe\  cr  which  came  under  our 
observation,  these  were  met  with  not  only  during  the  period  of 
haemoglobinuria  and  for  a  short  time  after  its  cessation,  but  also 
during  suppression,  when  only  a  very  small  amount  of  amber-coloured 
urine  was  being  passed.  (  asts  were  also  present  during  the  haeiiio- 
globiiuiria  cxperimcntall)-  produced  in  rabbits,  already  described  in 
the  preceding  section.  For  convenience  of  flescription,  it  will  be 
better  to  take  first  the  appearance  of  the  susiiended  matter  in  the 
111  me  in  experimental  haemoglobinuria;  then  that  of  the  suspended 
luattei  in  the  urine  in  blackwater  fever;  after  which  the  condition  of 
the  kidneys  in  the  latter  condition  will  be  described,  and  lastly  the 
bearing  of  the  data  thus  obtained  upon  the  mechanism  of  production 
of  suppression  of  urine  will  be  considered. 
The  mine  of  all  the  rabbits  in  which  haemoglobinuria  had  been 
produced  experimentally  (Table  35)  contained,  with  one  exception, 
solid  matter  at  the  time  the  urine  was  voided.  The  urine  was  at  this 
time  free  from  the  ordinary  crystalline  or  amorphous  deposit  found 
m  mine,  especially  upon  standing,  and  the  solid  matter  which  it 
contained  (cp.  Table  39)  consisted  of  casts  containing  granules  of  a 
more  01  less  dark  colour,  scattered  sometimes  in  very  small  nuiiibersi 
