236 
3rd  day.  The  urine  was  still  red  coloured,  and  the  vomiting  was 
very  troublesome.  After  to-day  patient  was  unable  to  pass  his  urine, 
and  a  catheter  had  to  be  used  to  draw  it  off.  On  passing  a  catheter 
it  was  found  that  he  had  a  urethral  stricture,  which  rendered  the 
passage  of  the  instrument  difficult. 
4th  day.  General  condition  bad,  pulse  weak  and  frequent,  patient 
very  lethargic.  The  urine,  which  had  cleared  up  during  the  night, 
was  amber  coloured,  and  contained  considerable  quantities  of  albumin. 
qth  day.  Condition  unchanged. 
6th  day.  The  quantity  of  urine  secreted  has  diminished  con¬ 
siderably  in  amount,  being  only  500-600  c.cm.  The  vomiting  persists, 
and  the  pulse  is  very  frequent  and  irregular. 
lOth  day.  Patient  died  at  i  a.m.  this  morning.  During  the  last 
few  days  he  had  sunk  into  a  comatose  condition. 
Condition  of  blood. — 3rd  day.  At  10  a.m.  patient’s  oxalated 
plasma  was  of  a  dark  orange  colour  with  no  red  tint,  containing 
0'2  per  cent,  of  haemoglobin  in  solution.  No  methaemoglobin  bands 
were  visible  in  a  column  of  the  oxalated  plasma  eighteen  millimetres 
high.  No  autolysin  was  present  in  the  plasma,  and  no  malarial 
parasites  or  pigmented  leucocytes  were  found  in  the  blood.  The 
following  observations  were  made  at  37°  C.  with  the  patient’s  red 
blood  cells  suspended  in  o'g  per  cent,  sodium  chloride  solution  to 
which  quinine  bihydrochloride  had  been  added:  — 
No.  of 
Composition  of  Mixi'Ure  of  Red  Blood  Cells  and 
Quinine  Solution. 
ment. 
2*5  %  emulsion  of 
red  blood  cells. 
0*9  %  solution  of 
sodium  chloride. 
1-92  %  solution  of 
quinine  bihydro¬ 
chloride. 
0-65  c.c. 
3-0  c.c. 
0*1  c.c. 
2 
0-8  c.c. 
3*6  c.c. 
0*1  c.c. 
3 
1-05  C.C. 
1  j.*6  C.c. 
o-i  c.c. 
4 
1-3  c.c. 
5-6  c.c. 
0*1  c.c. 
Condition  of  spleen. — 3rd  day 
.  At  1 1  a.m. 
Haemolysis. 
Complete  at  end  of  z  Hour. 
Complete  at  end  of  zjhom 
Partial  at  end  of  3  hours. 
Trace  at  end  of  3  hours. 
a  spleen  puncture 
was  made.  Phagocytosis  of  red  cells  (by  about  i  per  cent,  of  the 
white  cells)  was  observed.  No  malarial  parasites  or  pigment  found 
