Annual report on the Medical Research Institute / 1909-.

  • Nigeria. Medical Research Institute.
Date:
[1923]
Catalogue details

Licence: Public Domain Mark

Credit: Annual report on the Medical Research Institute / 1909-. Source: Wellcome Collection.

    9/34 (page 7)
    The duration of hsemoglobinuria, in cases in which there was neither remission nor relapse and in which there was no suppression, f* was twenty-four hours (Cases (6) and (9)) forty-eight hours, (Cases (3) and (7)) sixty hours, (Case (2)) and ninety-six hours (Case 8)). Relapses occurred in four cases. In Case (1) the first period of haemoglobinuria lasted just over six hours. After a seven hours’ interval and following a rigor, the urine was again porter-coloured and it did not clear until thirty-nine hours later. In the interval the temperature had fallen, but it rose again during the relapse. The total period of hsemoglobi- nuria was forty-five hours, and recovery was rapid. In Case (5), the initial period of passing black water was seventy-two hours. The urine cleared gradually but remained “ smoky ” until the ninth day, when it again became very dark. During the ensuing five days hsemoglobinuria was persistent and the patient died on the thirteenth day of illness. This case might be described as one showing a remission. The temperature gradually fell from the second day to the sixth day, when it was normal but it immediately rose again regaining normal on the eleventh day and fluctuating thereafter until the thirteenth day. In Case (11) the initial hsemoglobinuria completely disappeared after ninety-six hours. The urine remained clear for forty-eight hours, but became dark red again and remained so for thirty-six hours, when death took place. There was some abatement of the fever when the urine became clear, the temperature then being about 101° F and it showed no rise when the relapse occurred. A series of relapses characterised Case (12). The first period of hsemoglobinuria lasted thirty-six hours. Forty-eight hours later the red colour returned and persisted for twenty-four hours. At the end of the sixth day of illness, after the urine had been clear for twenty-four hours, there was a relapse lasting seven-and-a-half hours. Two days later the urine was again reddish for four hours. On the tenth day, after a two days’ interval of freedom there were two relapses the first lasting four hours in the early morning and the other nine- and-a-half hours in the latter part of the day. And again on the follow¬ ing day two relapses occurred one lasting twelve hours and the other about two hours. The final relapse was noted at the end of the twelvth day but only one coloured specimen was passed, and progress was steadily maintained thereafter. The temperature was febrile during all this time but was steadily falling and the normal line was reached on the day after the last relapse occurred. As already noted death occurred in two of these relapsing cases, Nos. (5) and (11). In the two cases, in which suppression occurred and death followed, the hsemoglobinuria was obvious for the first twenty-four hours in Case (4) and thereafter no urine was passed. In Case (10) hsemoglobinuria was observed on the morning of the first day. There¬ after no urine was passed until the fifth day when two drachms of port-wine urine were passed, after which there was complete- suppression. The illness lasted seven days in Case (4) and six days in Case (10). Albuminuria, as a rule cleared up within twenty-four hours of the disappearance of the hsemoglobinuria but in Case (1) it persisted forty- eight hours, in Case (6) for seventy-two hours, and for six days in Case (8;, after the urine had regained a normal colour. The blood was examined in nine cases. The results are shown in Table V from which it will be seen that the parasite of subtertian malaria was found in only one instance, Case (8) and that by the medical officer in attendance. Smears were received at the Medical Research Institute from seven of the cases.