201 
brown  in  colour  ;  ])yrami(ls  swollen,  dark  almost  black,  with  a  striated 
asjiect ;  mucous  membrane  of  pelvis  showed  punctate  ecchymoses ; 
superficial  ecchymosis  on  surface  of  left  kidney,  about  half  an  inch 
m  diameter.  Intestines  distended  with  g-as.  Stomach  empty; 
mucous  membrane  congested. 
Recent  pleural  adhesions  on  right  side  ;  older  adhesions  on  left 
side;  pleural  cavities  obliterated.  Lungs  emphysematous  ;  .scars  on 
surface  of  upper  lobe  near  apex ;  numerous  calcified  and  caseous 
nodules.  Bronchial  glands  enlarged,  not  tubercular.  Pericardium 
contained  about  lo  c.cm.  of  clear  3--ellowish  fluid;  valves  of  heart 
liealthy  ;  myocardium  somewhat  pale;  cavities  of  heart  small. 
Bladder  normal  in  aspect.  Suprarenals  unaltered.  Pancreas 
natural  in  appearance. 
Microscopical  exannna/tun.  The  kidney's  presented  marked  dis¬ 
tension  of  the  tubules  and  malpighian  capsules.  In  some  of  the 
tubules  solid  material  consisting  of  coarse  brown  granules,  rarely 
exceeding  5/1  in  diameter,  together  with  irregular  masses  formed  b_v 
the  aggregation  of  these  granules,  and  sometimes  also  free  epithelial 
cells  and  finely  granular  or  flocculent  material,  were  found  partly 
filling  the  lumen  of  the  tubule  ;  further  details  are  given  on  |jp. 
TO/-118.  The  interstitial  tissue  was  free  from  haemorrhage  and 
showed  no  cell  infiltration  or  increase  of  connective  tissue.  The 
blood  vessels  contained  no  malarial  pigment. 
Ihe  liver  showed  slight  fatty  change  and  some  congestion,  but 
no  cirrhosis.  There  was  no  pigment  in  the  liver  cells  and  no  malarial 
pigment  in  the  blood  vessels  of  the  liver. 
The  spleen  exhibited  no  malarial  pigment. 
Blackwater  Fe\'er.  Case  S. 
Male,  about  thirty-eight  years  of  age.  Joiner.  C'hinaman. 
Has  lived  in  Delagoa  Bay  and- Chinde  for  ten  years.  First  came 
to  Nyasaland  two  years  ago.  During  this  lime  he  has  had  a  consider- 
