that  this  would  be  the  forerunner  of  an  attack  of  blackwater,  but  lih 
urine  remained  clear  and  amber  coloured.  Four  days  ago,  and  again 
three  days  ago,  fifteen  grains  of  quinine,  m  two  and  a  half  grain  doses, 
were  taken.  His  temperature,  however,  still  remained  persistently 
high.  Two  days  ago  he  took  twelve  and  a  half  grains  of  quinine; 
yesterday  he  took  fifteen  grains.  During  the  last  three  days  drank 
little  fluid  and  passed  little  urine. 
ist  day.  During  the  night  patient’s  temperature  rose  to  105°  F. 
At  S  a.m.  passed  3  50  c.cm.  of  dark  red  urine.  Has  considerable  consti¬ 
tutional  disturbance.  Skin  and  conjunctivae  of  a  yellow  colour. 
Sweating  profusely.  Spleen  enlarged,  projecting  about  one  and  a 
quarter  inches  below  the  costal  margin  at  the  end  of  inspiration, 
From  this  day  onwards  no  more  quinine  was  taken  by  patient. 
2nd  day.  Temperature  remains  low.  General  condition  good. 
Somewhat  depressed.  Vomiting  of  green  and  yellow  bile-stained 
mucus,  troublesome.  Pulse  good,  feels  fairly  comfortable.  Skin  still 
fairly  yellow.  Urine  amber  coloured;  total  amount  18  c.cm. 
3rd  day.  Vomiting  continues,  otherwise  general  condition  good. 
Pulse  not  feeble.  Began  to  perspire  when  a  hot  pack  was  applied, 
his  temperature  rising  to  I02°2F.  Total  urine  21  c.cm.  Received 
intravenously  at  4  p.m.  one  litre  of  O'g  per  cent,  solution  of  sodium 
chloride.  Slight  rigor  one  hour  later.  General  condition  showed 
considerable  improvement  after  saline  injection.  Vomiting  ceased. 
Retained  two  pints  of  fluid  drink. 
4th  day.  General  condition  good.  Received  subcutaneously 
800  c.cm.  of  saline  solution.  Felt  much  better  after  injection.  Total 
urine  1  i  c.cm. 
5th  day.  FI  ad  a  good  night.  General  condition  remarkably 
good.  Vomited  greenish  bile  on  one  occasion  only.  Takes  a  little 
semi-fluid  food.  Total  urine  17  c.cm. 
6th  day.  General  condition  good.  Slight  vomiting  once  to-day. 
Takes  and  retains  a  little  food.  Flad  slight  dyspnoea  twice  yesterday. 
Total  urine  35  c.cm. 
