207

   11th July 1908.—Hæmoglobinuria still continues. Temperature in the morningl 102.
Serum ruddy yellow tint. Estimation of the amount of hæmoglobinæmia
gives about 1.5% blood solution.

   12th July 1908.—Hæmoglobinuria over.

   13th July 1908.—Given quinine 5 grains.

   14th July 1908.–Given quinine 5 grains.

   15th July 1908.—No quinine administered.

   16th July 1908.—A relapse. Stated to have come on apart from administration of
quinine.

   17th July 1908.—Urine dark red. Temperature in the morning 105, in the evening 104.

   18th July 1908.—Temperature 103 in the morning, 101 in the evening. Hæmoglobinuria
ceased towards evening.

Case XXVIII—

          Mr. M—European Assistant. Aged about 29.

          Length of residence in the Duars.—Between four and five years all on one garden.

         Arrived in Duars.—December 1903.

      History.—Had a mild attack of Black-water Fever in May 1905. Used to get a good
deal of fever and did not take quinine regularly, only when fever occurred, and
then not for long. Has had a lot of fever since March 1908, and in the middle of
May 1908 had a mild attack of intermittent Black-water Fever lasting two
days off and on. On the 5th June went for a sea trip to Rangoon. While on
board ship had two relapses very slightly. Was not then taking quinine. The first
attack in May 1908 came on after taking quinine hydrochloride. Got back to
the garden on June 15th and was feeling very fit. On the 17th had a bit of fever
and took 10 grs. quinine hydrochloride and remained at work. Fever came on
again on the next day at 5 P.M. 9P.M. took grs. 5 quinine hydrochloride, and during
the night at 3-30 A.M. another grs. 5. Next morning took grs. 5 again at 7 A.M., and
another tabloid a little later on the garden. Went out to work. After coming in
at midday passed black urine at 2 P.M. but went out again into the garden for a
short time. Then came in and went to bed. Woke up at 9 P.M. shivering. Got
hot bottles, and finally began to sweat and bilious vomiting became troublesome.

   Notes.—5th day, June 23rd.—When patient was first seen he was found to be lying ill in
a bungalow near the tea house, within 20 yards of a line harbouring servants and