MEDICAL HINTS. 
m 
keeping the head constantly soused ; while this is being done a bath can 
be procured and the patient then undressed, or, better still, have his 
clothes cut off, because it is dangerous to lift such a patient about 
too much. Remember that when a patient is very ill and weak, he 
should not be allowed to stand or sit up suddenly, as he may faint. 
Delirium with high temperature, say 104° to 105° F., is a certain sign 
that the fever is doing harm, and must be reduced. 
Do not trust too much in drugs; cold water is absolutely necessary. 
Death from simple malarial fever is hardly known ; patients should he 
told this . 
Blackwater Fever . 
* 
Blackwater fever is probably a pernicious form of malarial fever, and 
derives its name from the colour of the urine. It must be remembered 
that dark-coloured urine is usual in all fevers; it is scanty during the 
height of the fever, especially if there is much sweating. If, however, it 
is obviously “ bloody, 5 ’ the case is more grave, but as a rule it is only 
men broken down in health, and those who have resided in tropical 
Africa for at least a year, who suffer from this complication. 
Symptoms, —In addition to the ordinary symptoms of malarial fever, 
the urine is dark, blood-like, often scanty, and may become entirely sup¬ 
pressed. The skin is yellow, there is frequent vomiting, and the vomited 
matter is usually of a green colour. 
Treatment. —Give twenty grains of quinine three times a day. If 
quinine cannot be retained by the stomach it must be given by the 
bowel, or five grains administered three times a day by hypodermic 
injection. 
A strong aperient, such as five grains of calomel, should be given early 
in the attack, to thoroughly open the bowels. 
If there is pain in the loins, apply poultices or fomentations; if the 
vomiting is persistent, apply a mustard leaf to the pit of the stomach. 
Some stimulant, such as ammonia or alcohol, is necessary. 
If the patient is very restless, an opiate, such as fifteen drops of 
chlorodyne, may be given. Skilled assistance is urgently called for. 
