V.  THE  MECHANISM  OF  PRODUCTION  OF  BLACKWATER,  | 
The  condition  of  the  unne  and  blood  plasma  in  respect  of  dissolved  i 
haemogdobin  in  blackwater  fever  has  been  studied  in  Section  3.  In 
the  same  section  also,  the’  relation  between  haemogdobinaemia  and 
haemoglobinui-ia  has  been  determined  experimentally  in  rabbits, 
while  the  condition  of  the  urine  and  of  the  kidiiej's  in  suppression  of 
urine  in  blackwater  fever  has  been  described  in  Section  4.  The 
problem  now  remaining  to  be  considered  iS"  whether  the  mechanism 
of  production  of  blackwater  is  identical  with  the  process  induced 
experimentally  in  rabbits.  Before  the  consideration  of  this  point 
can  be  entered  upon  it  will  be  necessary  to  make  fuithei  reference 
to  the  condition  of  the  haemoglobin  in  the  urine  in  blackwater  fever, 
and  in  particular  to  the  presence  of  red  cells  in  the  unne,  to  allude 
again  to  the  changes  undergone  b}^  haemoglobin  in  the  urine,  and  to 
describe  the  methods  adopted  for  the  estimation  in  urine  of  haemo' 
globin,  both  when  unchanged  and  when  altered  by  the  action  of  urine. 
Table  43.  Characters  of  the  urine  in  blackwater  fever,  in  respect  of  brown  coloration, 
unchanged  haemoglobin  in  solution,  and  red  blood  cells. 
No.  of 
Case 
Colour 
Haemoglobin  in 
solution 
1 
Porter  coloureil 
Present 
2 
Chocolate 
coloured 
Absent 
3 
Porter  coloured 
Present 
4 
Dark  red 
— 
5 
Claret  red 
Present 
6 
Porter  coloured 
— 
6a 
Brown 
Absent 
7 
Porter  coloured 
n 
7“ 
>5 
Present 
g 
n 
5J 
9 
n 
— 
10 
J5 
Present 
1  I 
n 
12 
Dark  red 
n 
13 
(Red) 
— 
14 
Porter  coloured 
Present 
14a 
n 
n 
15 
n 
n 
16 
n 
n 
'7 
jj 
1 
Estimation  of 
Red  blood  cells  haemoglobin 
(maximum  amount) 
Present  — 
„  i-4%(Ug.  lo) 
Present 
— 
0-8  % 
Absent 
%  .  , 
Absent  at  first,  appeared 
1-2  %  (Fig.  n) 
afterwards 
Present  *-) 
Absent  at  first,  appeared 
afterwards  i 
5) 
Absent 
2-6%  (Fig.  13) 
2-6  %  (Ug-  U) 
2-2%  (Fig.  13) 
Absent 
n 
n 
n 
Present 
3’o%  (Fig.  16 
1-8  %  (Fig.  1/ 
3-8  %  (Fig.  18 
0-8  %  (Fig.  19 
3.5%  (Fig.  20) 
