229 
Blackwater  Fever.  Case  14a. 
Male,  thirty-nine  years  of  age.  .Store  assistant.  Indian. 
See  history  of  preceding  attack  (Case  14).  Has  remained  in 
fairly  good  health  since  his  last  attack  of  blackwater  fever  three 
months  ago. 
1st  day.  lie  felt  unwell  this  morning,  and  took  ten  grains  of 
9uminc.  A.t  2-30  p.m.  he  was  seized  with  a  feeling  of  uneasiness, 
accompanied  by  vomiting  and  shivering.  At  3  p.m.  he  passed  red 
urine.  T.  ior4°  F. 
2nd  day.  Patient  remained  ill  all  day,  passing  porter  coloured 
urine  ;  vomiting  very  severe. 
3rd  day.  Shortly  after  midnight  he  had  a  rather  severe  rigor. 
T.  102°  F.  The  vomiting  continued  all  morning,  but  ceased  in  the 
afternoon,  when  the  patient  felt  much  better.  The  urine,  which  had 
been  amber  coloured  in  the  morning,  cleared  up  later  in  the  day,  and 
towards  evening  was  amber  in  colour. 
4th  day.  Patient  much  better;  the  temperature  was  normal,  and 
the  urine  dark  amber  coloured. 
Subsequently  the  patient's  recovery  was  uninterrupted. 
Condition  of  blood. — 3rd  day.  At  12-30  p.m.  blood  was  with¬ 
drawn  from  the  finger.  The  blood  appeared  watery,  and  patient’s 
o.valated  plasma  was  of  a  deep  orange  colour  with  no  red  tint, 
containing  0-2  per  cent,  of  haemoglobin  in  solution.  Very  faint  bands 
of  methacmoglobin  could  be  detected  in  a  column  eighteen  milli¬ 
metres  high.  On  examination  with  the  aid  of  the  haemocrit,  the 
patients  blood  was  found  to  contain  24  per  cent,  by  volume  of  red 
cells.  A  haemoglobinometer  reading  of  33  divisions  of  von  Fleischl’s 
scale  was  obtained  (equivalent  to  o‘i  per  cent,  of  wet  red  cells) 
Haemoglobin 
Volume  ^  37* 
