3io 
In all, the haemoglobin of 17 c.c. of normal blood or about jj 
grains of haemoglobin was passed unaltered in the urine. 
We should note that during the blackwater period and subsequent 
lexer up to the 23rd day, chlorides were markedly diminished in the 
urine and the specific gravity was rather low. 
During the febrile periods beginning on the gth and on the 
42nd days there was no scarcity of leucocytes such as occurred during 
the first febrile period, or such as occurs during ordinary malarial 
febrile periods ; but the mononuclear percentage was high all through, 
■is occurs during malarial fever and afterwards. Much bilious 
vomiting occurred on the 10th and nth days, and unaltered bile 
pigment was present in the faeces up to the 15th day. The patient 
had the usual jaundiced appearance during the second febrile period. 
Quinine, which had been stopped since the 10th day, was resumed 
m doses of one grain daily on the 35th day and two grains daily from 
the 41st to the 46th day, when it was stopped again on account of 
t le second relapse. The urobilin was not estimated during the third 
pyrexial period. 
On studying the case, we observe that the first pyrexial period 
110111 the 1st to the 4th day accorded exactly with our previous 
experiences with the thirty-three ordinary cases of malaria described 
in our first paper (‘ Enumerative Studies on Malaria’). The amount 
and type of fever, number of leucocytes, fall of haemoglobin, amount 
uiobilin excretion, and effect of quinine were precisely what we 
ould have expected from the number of parasites counted; and the 
thing may be said of the following apyrexial period. But the 
sequent events differed markedly from our previous experiences, 
lough no parasites whatever were found in numbers of thick film 
preparations, yet the fever, fall of haemoglobin, and urobilin 
.. 10 , n ' n * atcr febrile periods were so severe that they would 
usiia y e associated with, say, 50,000 parasites or more per c.mm. 
! C ype ° f fever ln t,lese periods also differed from that of the first 
, and fl ’° m that seen fe our cases of malaria. During the 
D peuod (of the gth day) the fever consisted of several severe 
sweat ^ m u °r day ’ accom panied by sharp rigors and profuse 
seen" . S 11 ° thCSe mUch more sev ere and continued than are usually 
third m cases of malaria, even with very many parasites. The 
yrexia period was very similar to the second one, except only 
