i6o 
Pyrexia  aiul  associatcrl  syinplonis,  consisliny  of  rigor,  sweating 
loss  ol  appetite,  vomiting,  malaise,  headache,  cramps  in  the  legs,  pau 
in  the  back,  cardiac  weakness,  collapse,  pain  on  micturition,  and  rapia 
anaemia,  were  met  with  in  varying  degree  in  the  cases  coming  undet 
our  observation,  as  the  clinical  records  show(])p.  17^)10256).  Generali) 
there  was  severe  constitutional  disturbance,  especially  at  the  onset  of 
Fig.  70.  filood  smear  of  calf  with  piroplasmo.si.s.  A  mononuclear  retl  is  | 
shown,  in  the  cytoplasm  of  which  is  a  partly  decolourised  red  cell  | 
together  with  numerous  small  vacuoles.  Five  free  red  cells  are  .seen,  s 
I.eishman's  stain,  x  1,000.  ■ 
haenioglobinuria,  but  subsequently,  when  haemoglobinuna  had  ceased 
these  SN-mptoms  gradually  subsided.  In  sixteen  out  of  the  twent 
observations  recorded  in  Table  49  it  will  be  noted  that  the  attadioi 
blackwater  was  ushered  in  by  a  rise  of  temperature  usually  reacliin, 
103°  F.  to  105°  F.  and  commencing  with  a  rigor.  The  symptoirr 
during  the  attack,  regarded  apart  from  the  haenioglobinuria,  weti 
similar  to  those  of  malaria.  Upon  recovery  more  or  less  weakness, 
anaemia  and  loss  of  flesh  still  remained. 
A  striking  feature  of  the  attacks  was  that  in  sixteen  of  the  twenl' 
attacks  investigated  the  onset  was  preceded  for  several  days  by  moR 
or  less  marked  general  disturbance.  This  lasted  in  fourteen  attack 
from  one  to  seven  days,  and  in  two  attacks  ten  and  twenty-one  da)5 
respectively,  as  will  be  seen  on  reference  to  Table  49.  Tlif 
preliminary  illness  was  regarded  as  malarial,  but  in  only  one  casf 
(C  ase  3)  were  malarial  parasites  found  before  the  onset  of  haemc 
globinuria  (they  were  sought  for  on  the  day  before  the  onset  n 
Cases  2  and  3). 
i  I  umnro»ncr  nurintr .  tMnMrti 
