20C^ 
suuuds.  Second  sound  al  liase  over  aortic  orifice  accentuated.  Live; 
not  palpable.  Liver  dulncss  not  increased.  Spleen  extends  at  the 
end  of  inspiration,  about  four  inches  beyond  the  costal  margin.  Spleim; 
dulness  consideralily  increased.  During  the  attack  of  blackwater  has 
had  pain  in  loins,  not  descending  into  testes  or  thighs. 
Condilion  of  blood.  8th  day.  On  pricking  patient’s  finger  the 
blood  obtained  was  watery  in  aspect.  The  red  cells  were  relatively 
small  in  amount,  and  rapidly  sank  in  the  (oxalated)  plasma.  Plasma 
light  yellow,  gives  a  faint  oxyhaemoglobin  spectrum,  but  no  metliae- 
moglobin  bands,  in  a  layer  eighteen  millimetres  high  ;  amount  o 
dissolved  haemoglobin  is  less  than  0’o6  per  cent.  On  testing  fo; 
autolysin  (eight  hours  after  withdrawal  of  blood)  complete  haemolysis 
was  obtained  in  two  and  a  half  hours  ( 1  able  29) ;  bacteria  were,  how¬ 
ever,  present  at  the  time.  (On  testing  blood  plasma  for  aiitolysiii 
three  and  a  half  months  later  a  negative  result  was  obtained.) 
No  malarial  yrarasites  found  in  blood  smear.  The  following  obser¬ 
vations  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  ;  — 
Composition  of  Mixturf.  of  Rf.d  Blood  Cells  and 
Quinine  Solution. 
Xo-  nf 
experi- 
iiicnt. 
2';  %  emulsion  of 
red  blood  cells 
0*9  %  solution  of 
sodium  chloride 
1-92%  solution  of 
quinine  bihytlro- 
1 
0-65  c.c. 
3*0  c.c. 
chloride  | 
O't  c.c. 
2 
■  0-8  c.c. 
3-6  c.c. 
0*1  c.c. 
3 
1*05  C.C. 
4-6  c.c. 
0*1  c.c. 
Haemolysis. 
Complete  in  i  hour 
Complete  in  2^  houri 
Trace  at  end  of  3  hoiin 
Condilion  of  urine. — 8th  day.  Yellow  in  colour.  On  adding! 
drop  of  acetic  acid  and  boiling  becomes  cloudy,  and  an  inconsiderable 
amount  (about  a  jiV  column)  of  whitish  precipitate  is  formed.  Contain! 
a  small  amount  of  suspended  matter  consisting  chiefly  of  pus  cdls, 
together  with  squamous  epithelial  cells  and  a  few  granular  raassei 
or  casts  of  a  faint  brownish  tint;  no  red  cells  or  stromata;  i 
granular  pigment. 
