Africa : blackwater fever in the tropical African dependencies : reports for 1912.

Date:
1914
Catalogue details

Licence: Public Domain Mark

Credit: Africa : blackwater fever in the tropical African dependencies : reports for 1912. Source: Wellcome Collection.

    29/92 (page 19)
    H es Blackwater fever. Malaria & Rainfall Chart for Entebbe. /9/2. Fa Feb fan Apr ‘ai aha val Au Sep Oct Nov Lec. a ee [| cpu) wee] ee fe] Tepe eet ka Pot a oo ae0ue A Cs samen for ee poe s LcPREEEEUETPER CECEEEEEEEEEES seid easel xd akc | oad anteleos pela tohabtleds doh ‘eilhdlo Mitkebed da bile: hal Heed ak (eloldh Wieldioludatst fp pnd del sbop [oh TH Meee: er weee wee. = $eeverante vente artatentetezezs Sigitimipiciicl mse anes = | RC Pies als! RACER | patasufantectee EN RLLTAKL CHEE py) BEN Gar BCC Re ee [ Se eeoe Cobererst ba a eae XN & = ocean = Personal history.— “a (a) Previous blackwater fever—Two of the thirty-two cases occurred in the same European child, aged nine years, who had had two attacks previously; three cases occurred in patients who. had had two previous attacks, and four occurred in those who had had one previous attack. (b) Previous malaria—In every case previous attacks of malaria are recorded, and in six, frequent attacks. (c) Quinine prophylaxis.—Of the thirty-two cases, nine had taken quinine prophylactically for a long period, either grs. 5 daily, or grs. 10 or 15 twice a week on consecutive days. The rest had either taken it only when they had fever, or irregularly when they felt run down. It is noteworthy that, according to the statements made by the patients, of the nine who took quinine regularly as a prophylactic, three were fatal cases. (d) Quinine as exciting cause —In no case can quinine be said to have been the ~ real exciting cause of an attack. (e) Exposure as a cause——In six, exposure or over-fatigue is recorded as the exciting cause. (f) Length of residence in Africa.—This varied from one year to twelve years, the average being just over five years. (g) Presence of parasites-——In most cases slides had not been taken before the blackwater fever showed itself, either because the medical officer was not called in in time or because the patient was taking quinine at the time. In eight cases subtertian (ring) parasites were found before the hemoglobinuria manifested itself. In no case were parasites found after the hemoglobinuria, even during pyrexia. (h) Duration of the blackwater—This varied from twelve hours to ten days, the average time being just over forty-eight hours. The case which lasted for ten days was a fatal one, in a European, at Gulu, who had almost complete suppression for eight. days with constant bilious vomiting and hiccough, and in which hemorrhage from the gums, and later from the skin, occurred before death. Relation to malaria.—These cases tend to show that there is a definite relation between malaria and blackwater fever, and also that a second or third attack is more likely to be fatal than a first attack. My own experience convinces me that blackwater fever is only likely to occur in those persons who do not take adequate doses of quinine during and after attacks of mara, - I think the theory that ae is a factor in the etiology of blackwater fever is too much emphasised, as I am convinced that many people do not take enough 31857 : C2