The  subsequent  specimens  of  the  urine  were  amber  coloured, 
contained  no  deposit,  and  gave  no  precipitate  on  acidifying  with  acetic 
acid  and  boiling. 
BLyVCKWATER  FEVER.  CASE  4. 
Male,  about  thirty-five  years  of  age.  Clerk.  Indian. 
Has  lived  in  Nyasaland  for  the  last  seven  years,  and  has  had  a 
good  deal  of  malaria  during  this  time.  About  ten  months  ago  he  had 
an  attack  of  blackwater  fever,  since  which,  except  for  occasional  severe 
headaches,  he  has  been  perfectly  well.  He  has  hardly  taken  any 
quinine  since  this  attack  of  blackwater  fever. 
On  the  first  day  of  the  present  illness  he  had  a  very  severe  head¬ 
ache,  and  felt  feverish  about  mid-day  to-day.  At  3  p.m.  T.  103°!. 
He  took  ten  grains  of  quinine.  At  7  p.m.  he  took  five  grains  0 
quinine.  At  g  p.m.  he  had  a  slight  rigor.  During  the  night  he  states 
that  he  had  great  frequency  of  micturition,  passing  water  about 
twenty-five  times  in  very  small  quantities. 
2nd  day.  When  he  got  up  this  morning  he  found  that  his  urine 
was  of  a  dark  red  colour.  He  passed  urine  five  times  to-day,  tlie 
colour  increasing  until  mid-day,  and  then  gradually  decreasing. 
Vomited  once  this  morning. 
3rd  day.  Headache  still  troublesome ;  no  vomiting ;  the  urine 
cleared  up  this  morning. 
4th  day.  Patient  better  ;  the  urine  was  amber  coloured. 
5th  day.  Patient  practically  well.  T.  g8'2°  F.  The  urine  was 
amber  coloured.  Spleen  large,  reaching  one  and  a  half  inches  below 
the  costal  margin. 
6th  day.  Five  grains  of  quinine  bihydrochloride  was  given  by  the 
mouth,  and  three  grains  subcutaneously.  The  urine  remained  amber 
coloured. 
From  the  7th  to  the  13th  day  the  patient  remained  well,  and  Ik 
urine  continued  to  be  amber  coloured.  Three  grains  of  quiniiif 
bihydrochloride  were  administered  thrice  daily  during  this  period. 
14th  day.  The  patient  commenced  to  feel  unwell  again  last 
evening.  This  morning  he  was  worse,  and  had  lumbar  pains,  whicl 
did  not  descend  into  the  testicles  or  thighs.  He  vomited  several 
times.  He  took  one  dose  of  three  grains  of  quinine  this  inorniaf 
