177 
On  the  1st  day  of  tlie  present  illness  he  got  up  feeling  very  well, 
and  took  five  grains  of  quinine.  About  noon  he  suddenly  became 
dizzy  and  had  a  rigor,  and  shortly  afterwards  he  passed  blackwater. 
2nd  day.  In  the  morning  patient  was  comfortable,  vomiting  was 
slight,  and  the  urine,  which  had  begun  to  clear  about  noon,  was  still 
deeply  tinged  red.  Pulse  84.  Temperature  normal.  The  spleen 
extended  one  and  a  half  inches  below  the  costal  margin.  The  liver 
was  also  enlarged.  At  9  p.m.  patient  was  not  quite  so  well. 
Temperature  103°  F.  The  urine  had  become  much  darker  again. 
3rd  day.  Patient  much  better;  the  vomiting  had  ceased  and  the 
urine  was  not  so  deeply  coloured.  Temperature  99‘5°  F. 
4th  day.  Patient  better  ;  the  urine  was  amber  coloured  and  the 
temperature  normal.  .Subsequently  the  patient’s  recovery  was  un¬ 
interrupted. 
Condition  of  blood. — On  the  2nd  day  an  examination  of  the 
patient's  blood  was  made  at  4-30  p.in.  No  malarial  parasites  and  no 
pigmented  leucocytes  were  found. 
3rd  day.  Blood  was  e.xamined  at  10  a.m.  No  malarial  parasites 
and  no  pigmented  leucocytes  found. 
4th  day.  Blood  films  were  examined  again  to-day,  and  no 
malarial  parasites  or  pigmented  leucocytes  were  found. 
/th  day.  No  malarial  parasites  or  pigmented  leucocytes  were 
found  in  films  made  from  the  patient’s  blood  to-day. 
15th  day.  No  isolysin  could  be  discovered  in  patient’s  blood 
plasma.  No  malarial  parasites  or  pigmented  leucocytes  were  found 
in  the  blood  films. 
Condition  of  urine. — On  the  ist  day,  at  2  p.m.,  the  urine  wms  of  a 
dark  red  colour. 
2nd  day.  The  urine  was  not  quite  so  deeply  coloured  at  noon 
to-day,  but  at  9  p.m.  it  became  of  a  dark  red  colour. 
3rd  day.  The  urine  was  of  a  reddish  colour  to-day,  but  became 
lighter  in  the  evening.  On  spectroscopic  examination  the  bands  of 
oxyhaemoglobin  were  seen.  Methaemoglobin  bands  were  absent. 
A  few  red  cells  were  present  in  the  urine. 
4th  day.  Urine  was  amber  coloured. 
15  th  day.  The  urine  wms  acid,  sp.gr.  roio,  amber  coloured  ;  no 
deposit  on  centrifugalising,  and  no  precipitate  on  acidifying  and 
boiling. 
M 
