225 
Blackwater  Fever.  Case  13. 
Male,  twenty-nine  years  of  age.  .  Missir)nary.  Furopean. 
Has  been  in  Nyasaland  for  five  years.  From  time  to  time  had 
attacks  of  malaria,  which  were  not  treated  with  quinine.  Had  a 
slight  attack  of  blackwater  above  a  year  ago. 
CASE  13 
DAY  or  DISEASE 
TIME 
fAt..clcuu, 
MOMrilNC 
vc'MiMa 
3 
7 
M 
3  7 
II 
- 
- 
- 
— 
107“ 
106“ 
105“ 
104“ 
-- 
105“ 
102* 
101“ 
100“ 
99° 
_ 
-• 
_ 
-f" 
9J1" 
-1- 
- 
Fig  77.  Blaclcvv;iLer  Fever,  Case  13.  Teinperature  Chart. 
Took  four  grains  of  quinine  yesterday.  Spent  the  day  working, 
in  a  hot  sun,  at  brick-making.  Stated  to  have  been  quite  well. 
This  morning  took  four  grains  of  quinine.  Remained  well  till 
mid-clay.  Became  seriously  ill  at  i  p.m.,  when  he  vomited  black 
material  like  coffee  grounds.  Temperature  was  then  40°  C.  (104°  F.) 
He  was  then  much  distressed,  and  complained  of  pain  in  the  abdomen, 
putting  Jiis  hands  to  the  hypogastric  region.  Passed  red  urine, 
described  as  ‘  looking  like  blood.’  Fie  became  delirious  and  violent, 
and  four  men  were  required  to  restrain  him.  In  his  delirium  bit  the 
forearm  of  another  missionary.  Temperature  continued  to  rise  to 
