205

   History.—Previously lived in Sylhet where he did not have any serious fever. Since
coming to the Duars has had fever not leas than once a fortnight and has been
home for this season. Had a previous attack of Black-water Fever at Bogra.
Has been one year at Indong.

   5th July 1908.—Noon.—Felt indisposed and took 10 grains quinine.

                             3 P.M.—Rigor.

                             4 P.M.—Passed high coloured urine, and noticed at the end of micturition
                                     some drops of blood coloured fluid.

                             7 P.M.—Passing hæmoglobinous urine.

                           10 P.M.—Seen by Dr. McCutcheon who noted histemperature to be 105,
                                   and took blood films.

   Seen by us 4 P.M. 6th July 1908.—Temperature 103. Passing dark red hæmoglobinous
urine. Yellow colouration distinct. Spleen 3 fingers below costal margin.
Splenic puncture performed.

   Blood.—Serum orange yellow. Blood received into citrate shows small amount of
hæmoglobinæmia. No solution of clot in the serum.

   Isotonic point.—5 P. M. 6th July 1908.

due to hæmoglobinæmia.

   Splenic blood received into hypertonic salt solution gave only same tint (approximately)
as peripheral blood. Stained with neutral red in 3% citrate solution showed many dark
staining corpuscles, more than were present in peripheral blood. Films showed large numbers
of macrophages of mononuclear type containing numerous red cell shadows. Phagocytosis
of red cells are present. Agglutination very noticeable. Spherocytes present. Malignant
tertian pigment scattered and in the form of reliquats.

          Hæmolysis Experiments—Vide Part IV, Chapter II.

   8th July 1908.—Hæemoglobinuria still present up to late in the day.
227 H. D.

3F