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3rd  day.  The  urine  was  amber  coloured. 
4th  day.  The  urine  was  dark  amber  colour,  sp.  gr.  I'oiS,  no 
deposit  on  centrifugalising,  no  oxyhaemoglobin  bands,  and  no 
precipitate  on  acidifying  with  acetic  acid  and  boiling. 
From  the  5th  day  until  the  13th  day  the  urine  possessed  the  same 
characters  as  on  the  4th  day. 
14th  day.  The  urine  became  red  again  this  afternoon  about 
2  p.m. 
15th  day.  The  I'ed  colour  of  the  urine  continued  all  day,  but  began 
to  clear  towards  evening. 
1 6th  day.  The  urine  was  amber  coloured  and  slightly  alkaline. 
On  centrifugalising  there  was  a  slight  deposit,  consisting  almost 
entirely  of  granular  casts  and  masses.  No  red  cells  nor  stromata.  A 
few  columnar  epithelial  cells  and  triple  phosphate  crystals.  Slight 
precipitate  on  acidifying  with  acetic  acid  and  boiling. 
17th  day.  The  urine  was  amber  coloured,  and  gave  no  precipitate 
on  acidifying  and  boiling. 
.Subsequent  specimens  of  the  urine  were  amber  coloured  and 
normal. 
Blackwater  Fever.  Case  5. 
Male,  thirty-seven  years  of  age.  Cook.  Goanese. 
Has  been  in  Nyasaland  for  ten  months.  States  that  he  has  not 
suffered  from  attacks  of  malaria.  Six  months  ago  had  an  attack  of 
blackwater  fever ;  was  ill  for  one  month,  the  haemoglobinuria 
extending  over  ten  days  and  gradually  subsiding,  without  any  relapses 
occurring.  Has  not  had  any  other  illnesses. 
1st  day.  Illness  commenced  with  rigor  and  profuse  sweating. 
Anorexia,  but  no  vomiting.  Has  not  had  quinine. 
2nd  day.  Illness  continues.  Took  ten  grains  of  quinine. 
3rd  day.  Rigor  commencing  at  6  a.m.,  accompanied  by  sever? 
constitutional  disturbance.  Passed  port-wine-coloured  urine.  Ha' 
lumbar  pain  (bilateral)  not  extending  into  testes  or  groins.  Took  ten 
grains  of  quinine. 
4th  day.  Urine  became  lighter  in  colour,  was  finally  faintly  red 
coloured.  Heart  and  lungs  normal.  Spleen  enlarged,  projecting  at 
end  of  respiration  about  one  inch  below  costal  margin.  Splenic 
