dulness  increased.  Liver  dulncss  normal ;  liver  not  palpable.  Is 
extremely  weak.  Took  ten  grains  of  quinine. 
5th  day.  Urine  at  first  red,  became  later  dark  amber  coloured 
with  no  red  tint.  Is  very  anaemic  and  weak.  Pain  at  epigastrum. 
Complexion  sallow.  Quinine  discontinued. 
Subsequently  patient’s  recovery  was  uninterrupted.  No  relapse 
occurred. 
Cojidition  of  blood. — 5th  day.  Blood  smear  towards  close  of 
haemoglobinuria,  at  i  p.ni.,  contained  no  malarial  parasites. 
6th  day.  Examination  made  at  10  a.m.,  twelve  hours  after  haemo¬ 
globinuria  had  ceased.  Blood  plasma  of  light  amber  colour ;  no 
autolysin  present ;  gives  faint  oxyhaemoglobin  bands,  O’  1 3  per  cent, 
of  haemoglobin  being  present  in  solution.  No  malarial  parasites 
present  in  blood  smear.  The  following  observations  were  made  at 
37°  C.  with  the  patient’s  red  blood  cells  suspended  in  O’Q  per  cent, 
sodium  chloride  solution  to  which  quinine  bihydrochloride  had  been 
added ; — 
No.  of 
experi- 
ment. 
Composition  of  Mixture  of  Red  Blood  Cells  and 
Quinine  Solution. 
Haemolysis. 
2*5  %  emulsion  of 
red  blood  cells 
0'9  %  solution  of 
sodium  chloride 
1*92%  solution  of 
quinine  bihydro¬ 
chloride 
I 
0’2  c.c. 
1*2  c.c. 
0*1  c.c. 
Complete  at  end  of  4  hour 
0-5  c.c. 
2*4  c.c. 
0*1  c.c. 
Complete  at  end  of  i  hour 
3 
0-05  c.c. 
4.6  c.c. 
0*1  c.c. 
Partial  at  end  of  3  hours 
4 
17  c.c. 
7*2  c.c. 
0*1  c.c. 
Unaffected  at  end  of  3  hours 
Condition  of  5th  day  (sample  of  twenty-four  hours’  urine). 
Sp.gr.  1018;  neutral  to  litmus  paper;  colour,  brownish  amber; 
contains  a  small  amount  of  brownish  deposit ;  after  centrifugalisation 
the  supernatant  liquicT  gave  no  oxyhaemoglobin  bands  on  spectro¬ 
scopic  examination;  on  acidifying  and  boiling,  about  one-fiftieth 
column  of  brownish  Avhite  precipitate  was  obtained. 
6th  day.  Characters  as  above,  except  that  on  acidifying  and 
boiling  slight  turbidity  appeared,  but  no  precipitate. 
