igo 
'file  deposit  in  the  urine  consists  of  liyaline  masses  of  casts  filled 
with  refractile  granules  of  a  faint  brownish  colour  (Fig.  25,  p. 
Many  of  the  casts  or  masses  contain  remains  of  nuclei,  and  sometimes 
vacuoles  are  also  seen.  No  red  cells  or  stromata.  No  brown 
amorphous  deposit.  No  crystals. 
Additional  note.  At  the  end  of  two  and  a  half  months  another 
attack  of  blackwater  occurred,  terminating  fatally  at  the  end  of  three 
days.  Patient  was  not  seen  by  a  medical  man,  and  no  further 
particulars  of  his  illness  were  obtainable. 
Blackwater  Fever.  Case  6. 
Male,  about  thirty-nine  years  of  age.  Locomotive  inspector, 
European. 
Has  lived  in  Rhodesia  for  fourteen  years.  First  came  to  Nyasa- 
land  five  months  ago.  Has  had  a  good  deal  of  malaria,  both  in 
Rhodesia  and  Nyasaland.  Three  years  ago  he  had  an  attack  of  black¬ 
water  fever,  and  a  second  attack  a  year  later.  Never  taken  quinine 
unless  ill.  Four  days  ago  he  began  to  feel  ill,  but  was  able  to 
continue  at  his  work  until  yesterday,  when  he  was  decidedly  worse. 
He  thought  he  had  malaria,  and  took  three  doses  of  quinine  of  ten 
grains  each. 
1st  day.  Was  very  unwell  all  to-day,  and  in  the  evening  he 
noticed  that  his  urine  was  red.  T.  103°  F. 
2nd  day.  The  urine  continued  red  all  day,  and  the  patient’s 
general  condition  was  unchanged.  Vomiting  very  troublesome; 
spleen  enlarged  and  palpable.  T.  g8'2°  F. 
3rd  day.  Patient  was  rather  better  this  morning.  Urine  became 
clear  during  the  morning.  Vomiting  was  still  troublesome.  T.  gST, 
4th  day.  Vomiting  ceased,  and  patient  felt  much  better.  Urine 
amber  coloured.  T.  g8'2°  F. 
Condition  of  blood. — 3rd  day.  At  4  p.m.  the  oxalated  plasma  was 
found  to  be  of  a  dark  orange  colour  with  no  red  tint,  and  gave  in  a 
column  18  mm.  high  faint  bands  of  oxyhaemoglobin,  equal  to  o’lfipet 
cent,  of  haemoglobin.  No  isolysin  and  no  iso-agglutinin  were  present 
in  the  patient’s  blood  plasma.  No  parasites  and  no  pigmented  leuco¬ 
cytes  were  found  in  the  blood. 
Condition  of  urine. — ist  day.  In  the  evening  the  urine  was 
porter  coloured. 
