I.ll 
cells  in  Case  7a  and  22  g.  in  Case  1 1,  was  not  so  liigh  as  in  Cases  14 
and  17,  not  of  unusual  severity,  in  which  the  total  amounts  of  haemo¬ 
globin  were  equivalent  to  75  g,  and  32  g.  of  wet  red  cells  respectively. 
Tabi-f.  45.  Amount  of  haemoglobin  passing  into  the  tirinc  in  blackwater  fever. 
No.  of  Case. 
Haemoglobin  present  in  urine  during  attack,  expressed  in  terms 
of  equivalent  weight  of  wet  red  cells. 
■I  g- 
7 
'■5  g- 
7 
qg- 
TO 
s  g- 
1  1 
22  S’. 
u 
75  g- 
14  a 
20  g. 
K 
U)  g. 
16 
6-5  g- 
>7 
27  g. 
'the  presence  of  red  cells  in  the  urine  in  blackwater  fever  suggests 
the  inquiry  whether  the  haemoglobinuria  of  blackwater  fever  may  not 
be  really  dependent  upon  I'enal  haemorrhage.  In  the  earlier 
descriptions  of  cases  of  blackwater  fever  the  condition  of  the  urine 
was  often  described  by  using  the  term  haematuria,  the  condition  ol 
haemoglobinuria  not  having  at  that  time  become  differentiated  from 
that  of  haematuria.  Subsequent  -writers  recognised  that  the  condi¬ 
tion  present  in  blackwater  fever  wais  haemoglobinuria,  and,  so  far  as 
we  know,  no  recent  writer  has  described  haematuria  as  a  seciuence  of 
the  administration  of  quinine  in  malarial  subjects.  In  the  haemo¬ 
globinuria  produced  by  the  administration  of  potassium  chlorate  or 
other  poisonous  substances,  or  by  the  injection  of  a  haemolytic  serum 
(see  p.  128),  the  presence  of  red  blood  cells  in  the  urine,  in  addition 
to  dissolved  haemoglobin,  is  recorded,  but  in  our  experiments  on 
rabbits  this  did  not  occur.  The  possibility  of  blackwater  being 
])rimarily  due  to  renal  haemorrhage  was  impressed  u|3on  us  in 
particular  by  Case  2  (pp.  178  to  181),  in  which  the  red  cells  were  very 
numerous,  while  the  urine,  after  centrifiigalisation,  although  porter- 
eoloured,  did  not  exhibit  oxyhaemoglobin  bands  on  spectroscojiic 
e.xamination.  If  renal  haemorrhage  really  occurred  in  blackwater 
fever,  the  red  blood  cells  escaping  into  the  urinary  passages  would 
necessaril)'  become  laked  in  all  cases  in  which  the  specific  gravity  of 
