THE UNIVERSITY OF LIVERPOOL

ANNALS

TropicAL MEDICINE AND PARASITOLOGY

ISSUED BY THE

LIVERPOOL SCHOOL OF TROPICAL MEDICINE

VOLUME III (Octoter 1, 1909, to March 21st, 1910)

I] Ltp f2Cent\ -1W0 Plat y, eighty-four figures ii the text, and One Wap

LIVERPOOL: AT THE UNIVERSITY PRESS LONDON : CONSTABLE & COMPANY LTD., 10 ORANGE STREET, LEICESTER SQUARE, W.C,

£

She ote 4 FS ape ted

CONTENTS

No. I

Barratt, J. O. Waketrn ; and Yorke, WARRINGTON.

An Investigation into the Mechanism of the Production of Blackwater. Plates

I, Il, figures 1-82

No. 2

KinGHoRN, ALLAN ;: and Montrcomery, R. Eustace.

On the Flagellates occurring in the Intestine of Glossina palpalis, and in the

Intestine and Proboscis of Glossina morsitans

KINGHORN, ALLAN ;: and Monrcomery, R. Eustace.

Second Report on Human ‘Trypanosomiasis in North-Eastern Rhodesia and

Nyasaland

Monrcomery, R. Eusrace; and Kincuorn, ALLAN.

\ further Report on ‘T'rypanosomiasis of Domestic Stock in Northern Rhodesia

(North-Eastern Rhodesia). Plates II], IV, and map

No. 3

CARDAMATIS, JOHN.

Sanitary Measures and Malaria Epidemics of Athens. | Plates V-VII

Day, H. B.: and Fercuson, A. R.

An Account of a Form of Splenomegaly with Hepatic Cirrhosis, Endemic in

Egypt. Plates VIII-XII

Bremnt, Anron ; and Nierenstein, M.

Bio-Chemical and ‘Therapeutical Studies on ‘l'rypanosomiasis

PAG!

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379

395

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CONTENTS

No. 4

Newsreap, Roperr. PAGE Reports of the ‘I'wenty-first Expedition of the Liverpool School of ‘Tropical Medicine. Jamaica, 1908-1909; Section I—Medical and Economic Entomology. Part 1—Ticks and other Blood-sucking Arthropoda. Plates XITI-XV, and 1 figure in text. ; . Prout, W. T.

Reports of the ‘Twenty-first Expedition of the Liverpool School of Tropical

Medicine. Jamaica, 1908-1909 ; Section [I—Malaria. Plates XVI-XVIII 471

No. 5

Brent, Anton : and Hinpie, Enwarp.

Observations on the Life History of Trypanosoma lewist in the rat louse

(Haematopinus spinulosus). Plates XIX, XX 553 Yorke, WARRINGTON, On the Variation of the Haemolytic Complement in Experimental ‘Vrypano- somiasis.. ; . 665 KENNAN, R. H. Acute Craw-Craw. Plates XXI, XXII : i

Witicocks, F. C.

A Preliminary Note on the Prevalence of Mosquitoes in Cairo and its Environs 583

Boyce, Rupert; and Lewis, F. C.

The Effect of Mosquito Larvae upon Drinking Water .: Se

ee mee

INDEX

ae aaa a Se naner eer essere sssrssesrerserenssss

INDEX

INDEX or AUTHORS

GENERAL INDEX.....

Iepex OF Brecres NEW TO GCRMCR . ....on ccc noc nc cnn wee ev eennll eS

INDEX OF

PAGE |

Barratt, J. O. Wakelin; and Yorke,

Cakes m4 Boyce, Rubert ; and Lewis, F.C. ... 591

Breinl, Anton; and Neirenstein, M. 395 Breinl, Anton; and Hindle, Edward 553 | Cardamatis, John .......... . 5 Day, H. B.; and Ferguson, A. R.. 379 «| Ferguson, A. R.; and Day, H. “ee 379

Hindle, Edward; and Breinl, Anton 553 ee ee en aa Kinghorn, Allan; and Montgomery, | We. QGRAGS cen sine s sehen vaccine ey aee GENERAL PAGE Amblyomma cajanense ............ 440, 449 ISHII oon cnn ss ee o MAERIGINOE oo s cnc ox son vasa Anopheline breeding pools. Plates MEME ccc anaes px Serie io cetacean Anophelines of Athens caus Maven eee me Bionomics of ............... 471 Egyptian ; Notes on breeding places of ... 583 List of Jamaican ......... 486 Mabbras PEEP sik obscene . 469 Antimony compounds, Effect of on Trypanosomes “ie asia: ae Anti-malarial measures in n Jamaica, ¢ etc. 472 gt Mk uiman ty Argas persicus . ieaies 434 Athens, Sanitary measures s and malaria epidemics of > s-ssuredbariniegacone kee ea Atoxyl .. 5 Van dubia tra amicek dene wen sane ae “a Derivatives of halts peasne asi A tylotus Jamatcensis, N. sp. ...... . 465 Barratt and Yorke. The mechanism of production of Blackwater ............ 0 J Birds destroying ticks .................< 447

PAGE iil ili

Vii AUTHORS

PAGE

Lewis, F. C.; and Boyce, Rubert... 591 Montgomery, R. Eustace; and

Kinghorn, Allan segues OGO, 297, 341

Neirenstein, M.; and Breinl, Anton 395

Newstead, Rowers. ...5c.5iK.2........2. 423i PROUT Es ee cinereus. OF Wileoent, Fi Cy 2.054. Ga... 683 Yorke, Warrington ; and Barratt, J. QO. el gk het Se: ee ae Oe Pee Ve i cet is so xeens S08 INDEX PAGE Birds, Food of Jamaican ©..... 449

Blackbird, Parrot-billed ,feedingon ticks 451 Blackwater, An investigation into the

mechanism of came

oe aha ot oe I Blood cells, Haemoly sis pr

red, by quinine bi-

hy drochloride ......... 18 Blood Cells and Giteies

solution, Composition

of mixture of ............ 16 Clinical records of ...... 174 Haemoglobinaemia, Rela-

tion of to haemoglobi-

DETR eases Haemolysinaemia, Rela-

tion of to the Haemo-

globinuria in .......... 62 ; Haemolysis of red iso cells by Wateme......... 13 . Haemolysis of red blood cells Dy aid ............ 1 Haemolysis of red blood cells by alkali: ..:........ 13

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PAGE PAGE

Blackwater, Haemolysis of red blood cells by urine. a Hydrochloric acid, ‘Action ‘of, on red blood cells... lcteres and ay Introduction to Report on aaa Kidneys, the condition in is List of contents of Report on ? Mechanism of produc- tion of <& Prophylaxis and ment of . isd a Quinine, Action ok on red blood cells affected with malarial parasites Quinine, Action of on red cells during blackwater fever Ps aaa m Quinine, Action of on healthy red cells in the ving GOGy .....665... ‘i Quinine, Hydrochloric acid and sodium hydrate, Action of on red blood cells, com- pared . peeves i Quinine in the tenis: ‘a alkaloid on red blood cells, Action of . Quinine in the slkaloidal state, Nature of the action of, on red blood cells ae Sodium hydrate, Action of on red blood cells... +9 Summary of results ...... y Summary = Summary of report on... Tables, Index of Urine, the action of on red blood cells, and on dissolved haemoglobin Urine, Mechanism of pro- duction of suppression of, in Boyce and Lewis. mosquito larvae water.....

treat-

The effect of upon drinking

20 170

49

44

+3

19

21 60

..92, 135, 165

169

- a

Brein] and Hindle. On the lite- history of T aang’ lewisi in the rat louse Breinl and Nierenstein. Bio-Chemical and therapeutical studies on Try- b panosomiasis............ Bufo marinus Bull Frog ; Cairo, ne places of Anophelines in . ; Se tauetows Cardamatis. On sanitary measures and malaria epidemics of Athens... Cattle, Distribution of, in North- Eastern Rhodesia . ,, Washes and dips Core PI ovis sein cuew in Sop ece es Chrysomyia macellaria, Larvae of in man .... Chrysops costalis . Sees Cirrhosis, An account of a form of splenomegaly with hepatic, endemic in Egypt .. ms Clinical records of blackwater fever. Craw-craw, Acute ............ Crithidia sp. in Hacmatepinus spin gion tne piunh Crotophaga ant, i, feeding on ‘ticks caxiia Culex fatigans .. ; Culex spp., effect of larvae of on drink- ing water . Cyclops sp., effect of on n drinking v water Day and Ferguson. <A form of Splenomegaly with hepatic cirrhosis, endemic in Egypt Dermacentor nitens ........ Dermatophilus (Sarcopsylla) penetrans Dipterous flies infesting man ........ Di-sodium Azobenzene 4-arsenate ... Distomum hepaticum sine Celi Dysdercus sp. ..... sidighian nei Egypt, A form of splenomegaly with hepatic cirrhosis, endemic in.. Egyptian Anopheles, oe places Oe nrsetens ' Ferguson and ‘Day. “A form. of Splenomegaly with hepatic cirrhosis endemic in Egypt ............. Flagellates occurring in the intestine of Glossina palpalis, and in the intestine and proboscis of Glossina sacitsttiesop adit tt er ea

593

379 - 439 469 466 404

- 317

451

- 379 . 583

- 379

a4 259

ME ea URE Se aes

Formylo-Atoxyl, Effects of on Tryp- anosomes .. Sp ij Raine 7 Game, African. A list of the species examined for trypanosomes Gland palpation and puncture ...... Glossina fusca in North-Eastern Rhodesia ss in Nyasaland ......... Glossina morsitans, Flagellates occur- ring in the intes- tine and pro- boscis of habits of Incidence of intes- tinal contamina- tion in : Incidence of ater - tion in proboscis <i in North-Eastern Rhodesia in Nyasaland ...... in North-Western Rhodesia in relation to the distribution of eR arene Ries in association with wild game ...... Morphology of Trypanosomes found in * ‘i Ratio of sexes in... Glossina palpalis, Feeding experi- ments with ...... Flagellates occur- ring in the intes- tine of Habits of ....... Incidence of intes- tinal contamina- tion in Incidence of Sliies tion in proboscis in North-Eastern Rhodesia in Nyasaland ...... in association with

CRONE Ssirecvcsusnacsees Morphology of forms of ‘l'rypano- somes found in...

PAGE

404

371

291

265 263

+ de 271

tN

N Mur otis

262 264

281 283

>) &

te On a

Glossina palpalis, on shores of Lake

Tanganyika ...... physical characters of the country in which found ...... Ratio of sexes in. Glossitia spp. in relation to disease Map showing distribu- tion of i es ‘Trypanosomes, Wild forms in .. Grabhamia willcocksii a Haematopinus spinulosus, On the =. history of Trypanosoma lecwisi, in Haemoglobinaemia, Relation of to haemoglobinuria i in blackwater fever Haemolysinaemia, Relation of to the wii aia iamay in Blackwater fever. : Rena Herpetomonas i in rat ra Yonah Sp Aa Hindle and Breinl. On the life- history of Trypanosoma lewist in the rat louse aes Hippoboscidae of bats and birds. 497, Homophoeta equinoctialts............ Horn-fly in Jamaica ERE TE. Hydrochloric acid, Action of on red blood cells ........ i , Sodium hydrate and Quinine, Action of on red blood cells ...... Icterus and Blackwater fever............ Ixodes bovis. (See Margaropus annu- latus) ricinus, Reputed occurrence of in Jamaica., pet ene aa scapulatus. (See Amblyomma cajanense) [xodoidea in Jamaica Jamaica, [xodoidea of Resbeses Report on Malaria in ...... Ticks and other blood-suck- ing Arthropoda in ......... Kennan. Acute Craw-craw ......... Kharsin. .

Kidneys, ‘ha cnadician ak: in ; tek water fever ae Sane Kinghorn and Montgomery. “On Try- panosomiasis of domestic stock in Northern Rhodesia

99

ss

AGE

279 . 262 328

22 170

422

421 421 471% 421 406

166

311

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yee ee ee ee

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see

sb ah ar toa

PAGE Kinghorn and Montgomery. On the flagellates occurring in the intestine of Glossina palpalis . Seaton es: Se Lewis and Boyce. The effect of mosquito larvae upon drinking water... eed Herd a ead ee Libellulidae, natural enemies of mos- quito larvae 588 Lizards, Food of . 454 Louse, Rat. Observations on n the life- history of a eas lewist in the 553 Loxa flavicollis... = 452 Lyperosia irritans in Jamaica ... 463 Malaria, Epidemics of, Athens, Sani- tary measures and............. 375 General history of 78 in children at Athens, com- parative tables . 377 in Jamaica, Report o on. 471 Malarial parasites, Action of on “ted blood cells, affected with malarial parasites . 49 Margaropus annulatus, var australis 435, 449, 452 Mosquito larvae, Effect of on srsse ose water iy 591 Mosquitos in Cairo and environs 583 Natural enemies of . 588 Montgomery and Kinghorn. On the flagellates occurring in the intestine of Glossina palpalis 259 Montgomery and Kinghorn. On Try- panosomiasis of domestic stock in Northern Rhodesia ............ 311 Myiasis in man Saath arc caaprenen sy ce ee Newstead, Ticks and other blood- sucking 4¢rthropoda in Jamaica ...... 421 Niernstein and Breinl, Bio-chemical and therapeutical studies on Try- DORON oS icra ss ee Notonectidae, Natural enemies of mosquito larvae 588 Ornithoctona erythrocepbala ee ey Orsudan, C. . pew cewees glib 408 Piroplasmosis, Redwater in... 165 Polistes crinita in stomach of ‘Croto- phaga ant. 451 Prophylaxis | and treatment gf Black- water fever eee 171 Prout, Malaria in Jamaica... 471

Pyretophorus cleopatrae ui SUUTIMETES (5 <<. wuss covets v9 Quinine, Action of on red cells during blackwater fever .......... Action of on red blood calle affected with malarial parasites ‘s Action of on healthy ved cells in the living body bihydrochloride in plasma hydrochloric acid al a ae hydrate, Action of, on red blood cells in the alkaloidal state, Navure of the action of on red blood cells . in the form of alkaloid on me blood cells, Action of ...... use of in acute attacks of sy Ouiscalus crassirostris, feeding o on n ticks Redwater in piroplasmosis Rhipicephalus sanguineus pci Rhodesia. On ‘Trypanosomiasis of domestic stock in Northern Sanitary measures and malaria epi- demics of Athens.. Tpbsradt (See ‘ie Trvon :no-

s5

blood

Sleeping sickness. somiasis) Sleeping sickness, Mode of introduc- EE REL ete Occurrence of cases of ae 7" me Prophylaxis Sodium Veer arsenate = di-p- amino- phenyl-arsenate Action of on red blood cells ........ Quinine and Hydro- chloric acid,Action of on red blood cells Re p-hydroxy-phenyl-arsenate Splenomegaly with hepatic cirrhosis, An account of a form of, endemic in Egypt

Stock, Disease in

“4 74

c hydrate,

PAGI 586 375

44

49

43

18

nN ~J

19

533 448 165

437

311

301

300 302

22 405

2 ww wm ss

on es

“1 SERIE LORENA INT NL. eH

Stomoxys and ' responsible = gg crepuasalaiiaie of Trypanosomiasis ......... ee

Stomoxys calcitrans in Jamaica ..

Tabanidae and Stomoxys, sabieinod to distribution of in Rhodesia

Tabanus sp.,

PAGE

banidae, said to be

reference to

Tetra sodium phenazine 4-arsenate Theobaldia annulata ...........c0cccc eee Theobaldinella spathipaipis . ...... 574;

Ticks and

i)

bP)

99

other blood-sucking

Arthropoda in Jamaica ...... Apparatus

cattle

for spraying infested

Dissemination of nat various

agencies

E fkec t of Rainor Wz ateron ...... Life- cycles of

Longevity

of without hose

Natural enemies of Prevailing conditions of sadiadind

pastures. aie os Results obtained by” burning

infestéd pastures .......-....... Seasonal prevalence of in

Jamaica ah Structural Ginuecvies of see

Synopsis of Jamaica species ... Trichobius parasiticus Trypanosoma cazalboui

dimorphon .......+..-- 3455

/

lewist, Observations on

the life-history of in the rat louse Haema- topinus spinulosus ...... Morphology of Balungu

site 55. Morphology of ‘Chunga serait: sa; Morphology of Kambola strain

Morphology of ‘Nisam: wenda strain

Morphology of Scotedale strain

Han

s5

um

ss ee - 329,

spp.,

effect id colouring TAATECTS- OR 5.4... effect of drugs on

331 464

331 315 495 592

597

421

+ a ™sI

Ww

Ww

te

~~ eS He + oe N SIs] Cvwr wu

> tv m

+ wa wo

424 430 432 468 329 373

wi Ww =>)

we ‘41 _

344 329 373

409 406

Trypanosomes,

P Trypanosoma spp., "Reference to several African ...... 347; Effect of etc., on wae, in n aturally indetved pig Seid é is ce « in naturally Sediered dogs nile be «: in naturally infected Ruminants

os)

73

‘Trypanred, somes Tsetse flies.

in African game ......

Methods of staining... Morphology of cattle

Morphology of forms found in Glossina palpalis ..

Origin of ‘Wild’

forms in Glossina

Permanent cure of in animals cea:

Reappearance of after treatment with drugs

Resistance of to drugs ‘Transmission of cattle

Trypanosomiasis, Bio-Chemical and

Therapeutical

Studies on Comparative value of experiments on in North-Eastern Rhodesia and Nyasaland, Second report on Human of domestic stock in Northern Rho- desia, A further re- port on agape of domestic stock,

supp. note On the variation of the haemolytic com- plement in experi- NS se

Prophylactic measure for... Effect of on ‘Trypano-

(See also Glossina)

AGI

566

396

417 413 374

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ih eile tc aces gran

ee me En Oe et ee ee

PN it NO J Ny ear

ee

~*

Se ee enn

en ere

paca eibbind dike” ingen Giese fc

natures soem

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PAGE Tsetse flies, distribution of in North-

Eastern Rhodesia ...... 281 Map showing distribution of in Rhodesia ......... 374

Urine, Mechanism of production of suppression of in blackwater NWN ities cues ae ‘The Action of on red blood cells and on dissolved haemo- globin roby edi W Swe nesbebeveneweres Se

INDEX OF SPECIES

[tylotus jamaicensis, Newstead ...............

Willcocks, Mosquitos in Cairo and its environs Eben Was vba kad Vounueestaws Yorke and Barratt, The mechanism of production of Blackwater ............ Yorke, On the variation of the haemo- lytic complement in experimental

TTyPAMNOM sal ei

NEW TO SCIENCE

, wbaban dete Wile Scigspaked he ih er tb aes 405

seeuniienal i Ea ee ee ee a

AN INVESTIGATION INTO THE MECHANISM OF PRODUCTION OF BLACKWATER ,

BY J.O. WAKELIN BARRATT, M.D., D.Sc., Lonp.,

AND

WARRINGTON YORKE, M.D., LIVERPOOL

(Being the Report of the Blackwater Fever Expedition to Nyasaland of the Liverpool School of Tropical Medicine, 1907-1909)

(Recetved for publication 6 May, 1Q0Q)

CONTENTS

INTRODUCTION, p,. 12,

Section I. The haemolysis of red blood cells by quinine and also by acid, alkali

and urine.

(a) Action of quinine, acid and alkali on healthy red blood cells : action of quinine bihydrochloride in varying concentrations on red blood cells, p. 13; action of quinine in the form of alkaloid on red blood cells, p. 19; action of hydrochloric acid on red blood cells, p. 20 ; action of sodium hydrate on red blood cells, p. 21; action of quinine, hydrochloric acid and sodium hydrate on red blood cells compared, p. 22; nature of the action of quinine in alkaloidal state on red blood cells, rate of action of alkaloidal quinine, value of yz, comparison with pepsin, amount of quinine taken up by red blood cells, p. 27; action of quinine on healthy red blood cells in the living body, p. 42.

(b) Action of quinine on red blood cells during blackwater fever,

P+ 44.

SECTION

2

(c) Action of quinine on red blood cells affected with malarial parasites, p. 49. (d) Action of urine on red blood cells and on dissolved haemoglobin :

comparative experiments, p. 51; determination of reaction rate, value of b> P- 55-

(e) Summary, p. 60.

Il. The relation of haemolysinaemia to the haemoglobinuria of black-

water fever.

SECTION

SECTION

Introduction, p. 62; observations made during health, blackwater

fever and other affections, p. 66; summary, p. 68.

M11. The relation of haemoglobinaemia to haemoglobinuria. Introduction, p. 69. Is haemoglobinaemia present in blackwater fever ? p. 70; is haemo- globinaemia in blackwater fever accompanied by haemoglobinuria ? p. 76. Is haemoglobinuria readily producible as the result of haemoglo-

binaemia? p. 80; relation between the degree of haemoglobinuria

and that of haemoglobinaemia in rabbits, p. 81; relation between the degree of haemoglobinuria and that of haemoglobinaemia in blackwater fever, p. 86; comparison between the amount of dissolved haemoglobin injected in rabbits and the quantity appearing in the urine, p. 89; rate of disappearance in the living body of dissolved haemoglobin from the blood plasma, p. 89; rate of disappearance in vitro of dissolved

haemoglobin from the blood plasma, p. go.

Summary, p. 92.

?

IV. The mechanism of suppression of urine in blackwater fever.

Introduction, p. 94.

Solid matter in the urine: in experimental haemoglobinuria and in redwater, p. 94; in blackwater fever during haemoglobinuria,

p- 98; during suppression of urine following blackwater fever, p. 103.

Amount of urine passed during suppression, other characters, Case 16,

p. 106.

SECTION

»] J

Condition of kidneys during suppression of urine following black-

water fever, macroscopic and microscopic, diagrammatic representation, p. 107; Case 16, p. 119.

Condition of kidneys of rabbit during haemoglobinuria dependent upon haemoglobinaemia, diagrammatic representation, p. 124; of cattle and dogs during redwater, p. 127.

Condition of kidneys of rabbit during anuria produced by poisoning with potassium chlorate and other poisons, and by the injection of hae-

molytic serum, p. 128. Mechanism of suppression of urine, p. 131. Source of urine during suppression, p. 134.

Summary, p. 135.

V. The mechanism of production of blackwater.

Introduction, p. 136.

Condition of haemoglobin in the urine in_ blackwater fever: dissolved haemoglobin, p. 137; red blood cells, p. 137; estimation of haemoglobin in urine, p. 138; total amount of haemoglobin lost in the urine in blackwater fever, p. 140.

Mechanism of production of blackwater, relation of blackwater to haemoglobinaemia : significance of red blood cells in the urine, p. 141; alternative hypotheses, primary haemoglobinaemia and primary renal haemorrhage, p. 142; | primary haemoglobinaemia considered in relation to the phenomena of blackwater fever, p. 142 ; primary renal haemorrhage considered in relation to the phenomena of blackwater fever, p. 146; conclusion, p. 150.

Situation in which laking of red blood cells may take place in black- water fever: in the blood stream, p. 150; in internal organs, p. 153; splenic enlargement, p. 153; splenic puncture, p. 154.

General symptoms, p. 160.

Blackwater and malaria, p. 160.

Blackwater and quinine, p. 163.

Summary, p. 165.

Additional note: mechanism of production of haemoglobinuria in

piroplasmosis, p. 165.

4

Section VI. Condition of the kidneys during blackwater fever. Relation of venereal disease to blackwater fever.

Introduction, p. 166; post mortem observations, p. 167; venereal disease, p. 169; summary, p. 169.

Section VII. Icterus and blackwater fever, p. 170.

Section VIII. Remarks on prophylaxis and treatment of blackwater fever, p. 171.

Section IX. Clinical records.

Review of cases of blackwater fever coming under observation, p- 174; Case 1, p. 176; Case 2, p. 178; Case 3, p. 181; Case 4, p. 186; Case 5, p. 188; Case 6, p. 190; Case 6a, p. 191; Case 7, p. 193; Case 7a, p. 195; Case 8, p. 201; Case 9, p. 205; Case 10, p. 207; Case i, p. 237; Caste 12, p. 222; Caste 3, p. 225; Case 14, p. 2260; Case 14a, p. 229; Case 15, p. 231; Case 16, p. 235; Case 17, p. 239.

Contents, p. 1.

Tables, p. 5.

Illustrations, p. 8.

J TABLES

Taste 1. Haemolysis of red cells by quinine bihydrochloride dissolved in 079% NaCl solution. Duration of experiment three hours. ‘Temperature 37° C.

Taste 2. Haemolysis of red blood cells by quinine bihydro- chloride, in nearly four times the concentration employed in Table 1. Duration of experiment three hours. ‘Temperature 37° C.

Tase 3. Haemolysis of red blood cells by quinine bihydrochloride, in nearly fourteen times the concentration employed in Table 1. Duration of experiment three hours. ‘Temperature 37° C.

‘Taste 4. Haemolysis of red blood cells by quinine bihydrochloride dissolved in the blood plasma. ‘Temperature of experiment 37° C.

Taste 5. Haemolysis of red blood cells by quinine in alkaloidal state. Duration of experiment three hours. ‘Temperature 37° C.

‘Taste 6. Haemolysis of red blood cells by hydrochloric acid dissolved in 09% NaCl solution. Duration of experiment three hours. Temperature 37° C. ak ns ree

Taste7. Haemolysis of red blood cells by sodium hydrate dissolved in 079% NaCl solution. Duration of experiment three hours. Temperature 37° C.

TasLe 8. Showing the relative amounts of human red cells completely haemolysed in three hours by quinine bihydrochloride, quinine in alkaloidal state, hydrochloric acid and sodium hydrate. ...

Taste 9. Haemolysis of red blood cells by quinine in alkaloidal state. Duration of experiment three hours. ‘Temperature 37° C.

Taste 10. Haemolysis of red blood cells by hydrochloric acid dissolved in 09% NaCl solution. Duration of experiment three hours. ‘Temperature 37° C.

Taste 11. Haemolysis of red blood cells by sodium hydrate dissolved in 0-9% NaCl solution. Duration of experiment three hours. ‘Temperature 37° C.

TaBLe 12. Comparison of the action on human red blood cells of quinine bihydrochloride, quinine in alkaloidal state, hydrochloric acid and sodium hydrate in the same molecular concentration. The amounts of red cells given were the largest amounts which could be completely haemolysed in three hours at 37° C.

TaBLe 13. ‘The rate of haemolysis of red blood cells by a 0°0358 % solution of quinine in o°9 % solution of sodium chloride. The ratio of the weight of wet red cells to the amount of quinine present is 12°6 : 1. Temperature of experiment 37° C.

TasBLe 14. Reaction rate constant of the experiments recorded in Table 13 re-calculated...,

PAGE

16

17

18

19

20

21

22

24

24

29

29

itl SAN lt St a a AE a il Sd Sh Si a Teg he

6

TasBLe 15. Comparison of percentages found in Table 13 and those calculated from the value of K = 0°0039.

Taste 16. The rate of haemolysis of red blood cells by quinine in the alkaloidal state. Conditions of experiment as in Table 13.

TasLe 17. Rate of haemolysis of red blood cells, at different temperatures by a 0'00113 M. (0'0366 %) solution of quinine in the alkaloidal state.

Taste 18. Determination of value of sz from experiments recorded

in Table 17. ... TaBLE 19. Comparison of values of K at different temperatures...

Taste 20. Determination of the amount of quinine withdrawn from solution by healthy human red blood cells. Duration of action of red blood cells on quinine sulphate dissolved in o-9% solution of sodium chloride, eighteen to twenty-four hours. ‘Temperature of experiment 17° C. to 19° C.

TaBLe 21. Determination of the percentage amount of quinine contained in red blood cells in the experiments recorded in Table 20.

TABLE 22. Quiniffe in relation to blackwater fever. Taste 23. Haemoglobinuria in relation to quinine in animals,

Taste 24. The haemolytic action of quinine bihydrochloride upon red blood cells during and after blackwater fever and malaria, Experiments conducted at 37° C. as in Table 1 (P- 15). Duration of experiment three hours.

TaBLeE 25. ‘The action of urine in pu up haemoglobin. Duration of experiment four hours. Temperature 37° C.

Taste 26. The rate of destruction of haemoglobin in red blood cells by urine at different temperatures.

TaBLe 27. Determination of value of 4 from experiments recorded

in Table 24. ...

TasBLe 28. Comparison of values of K at different temperatures.

Cp. Table 24.

TaBLe 29. Experiments made to ascertain if a haemolytic action on red blood cells could be obtained with the blood plasma of individuals suffering from blackwater fever.

TaBLe 30. Experiments made to ascertain if a haemolytic action on red blood cells could be obtained with the blood plasma of individuals suffering from malarial and other affections. Normal plasma was also employed in eleven observations.

TABLE 31. Examination of oxalated blood plasma for the presence of dissolved haemoglobin in healthy individuals.

TABLE 32. Examination of oxalated blood plasma for the presence of dissolved haemoglobin in patients not suffering from blackwater fever.

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TABLE 33. Examination of oxalated blood plasma for the presence of dissolved haemoglobin in blackwater fever patients.

TABLE 34. Examination of oxalated blood plasma for the presence of dissolved haemoglobin during the haemoglobinuria of blackwater fever. Selected from Table 33.

TaBLeE 35. Experimental haemoglobinuria in rabbits.

Tasie 36. Examination of oxalated blood plasma for the presence of dissolved haemoglobin in experimentally induced haemoglobinuria in rabbits. Selected from ‘Table 35.

laste 37. The rate of disappearance of dissolved haemoglobin from the blood plasma in the living body of the rabbit. Cp. Table 35.

TasBie 38. Decomposition of dissolved haemoglobin in oxalated or defibrinated blood plasma. ‘Temperature of experiment 37° C.

Tasie 39. Characters of deposit from urine of rabbit during haemoglobinuria experimentally induced. Cp. Tables 35 and 37.

‘Taste 40. Characters of deposit from urine during haemoglobinuria of blackwater fever.

Tasie 41. Characters of deposit from urine during suppression in blackwater fever (Cases 7A and 11). Case 16 is also given in this Table.

Taste 42. Average daily amount of urine passed during suppression of urine in blackwater fever. The colour of the urine was light yellow or amber.

Tasie 43. Characters of the urine in blackwater fever in respect of brown coloration, unchanged haemoglobin in solution and red blood cells.

Taste 44. Bulk of precipitate obtained on boiling 10 c.c. of slightly diluted urine, containing varying percentages of dissolved haemoglobin.

TasLe 45. Amount of haemoglobin passing into the urine in blackwater fever.

Taste 46. Examination of blood films in cases of blackwater fever. Taste 47. Condition of the spleen in blackwater fever.

Taste 48. Condition of parenchyma of spleen in blackwater fever and malaria.

Taste 49. Character of constitutional disturbance during blackwater fever and of preceding illness when present.

Taste 50. Showing the amounts of quinine (given in grains) taken before, during and after the attacks of blackwater fever investigated.

Taste 51. Blackwater fever and venereal disease.

TABLE 52. Synopsis of cases of blackwater fever investigated.

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ILLUSTRATIONS

1. Apparatus ais for testing haemolytic property of blood plasma. *

eae

2. Experiment 3, Table 35. Experimental haemoglobinaemia of rabbit. Percentage of dissolved haemoglobin in blood plasma and urine.

3. Experiment 4, Table 35. Experimental haemoglobinaemia of rabbit. Percentage of dissolved haemoglobin in blood plasma and urine.

4. Experiment 5, Table 35. Experimental haemoglobinaemia ofrabbit. Percentage of dissolved haemoglobin in blood plasma and urine,

5. Experiment 6, Table 35. Experimental haemoglobinaemia of rabbit. Percentage of dissolved haemoglobin in blood plasma and urine,

6. Experiment 7, Table 35. Experimental haemoglobinaemia of rabbit. rsa gh of dissolved haemoglobin in blood plasma and urine.

. 7. Experiment 8, Table 35. Experimental haemoglobinaemia

of rabbit. sisi of dissolved haemoglobin in blood plasma and urine.

8. Experiment 9, Table 35. Experimental haemoglobinaemia of rabbit. Percentage of dissolved haemoglobin in blood plasma and urine.

g. Experiment to, lable 35. Experimental haemoglobinaemia of rabbit. Percentage of dissolved haemoglobin in blood plasma and urine,

10. Blackwater fever, Case 3. Percentage of dissolved haemo- globin in blood plasma and urine.

. 11. Blackwater fever, Case 7a. Percentage of dissolved haemo-

globin in blood plasma and urine.

12. Blackwater fever, Case 8. Percentage of dissolved haemo- globin in blood plasma and urine.

13. Blackwater fever, Case 10. Percentage of dissolved haemo- globin in blood plasma and urine.

. 14. Blackwater fever, Case 11. Percentage of dissolved haemo-

globin in blood plasma and urine.

15. Blackwater fever, Case 12. Percentage of dissolved haemo- globin in blood plasma and urine.

16. Blackwater fever, Case 14. Percentage of dissolved haemo- globin in blood plasma and_urine,

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17. Blackwater fever, Case 14a. Percentage of dissolved haemo- globin in blood plasma and urine.

18. Blackwater fever, Case 15. Percentage of dissolved haemo- globin in blood plasma and urine.

19. Blackwater fever, Case 16. Percentage of dissolved haemo- globin in blood plasma and urine.

20. Blackwater fever, Case 17. Percentage of dissolved haemo- globin in blood plasma and urine.

21. Hyaline casts in urine of rabbit (Exp. 2, Table 35) four hours after intravenous injection of dissolved haemoglobin,

22. Granular and epithelial casts in urine of rabbit (Exp. 3, ‘Table 35) twenty hours after intravenous injection of dissolved haemoglobin.

23. Granular and epithelial casts in urine of rabbit (Exp. 5, Table 35) eighty-five minutes after intravenous injection of dissolved haemoglobin.

24. Granular and epithelial casts in urine of rabbit (Exp. 6,

Table 35) twelve and a half hours after intravenous injection of dissolved haemoglobin.

25. Deposit from chocolate coloured urine of blackwater fever, Cases 2 and §.

26. Deposit from porter coloured urine of blackwater fever, Case 3.

27. Deposit from amber coloured urine of blackwater fever, Cases 4 and 8,

28. Deposit from porter coloured urine of blackwater fever, Case 7.

. 29. Deposit from porter coloured urine of blackwater fever,

Case 7a.

30. Deposit from porter coloured urine of blackwater fever, Case 15.

31. Deposit from porter coloured urine of blackwater fever, Case 17.

3z. Deposit from light yellow coloured urine of blackwater fever, Case 7a. .

33. Section of cortex of kidney during suppression of urine, eight days after haemoglobinuria had ceased. Blackwater fever, Case 7a.

34. Section of medulla of kidney during suppression of urine, eight days after haemoglobinuria had ceased. Blackwater fever,

Case 7a,

35. Section of cortex of kidney during suppression of urine, eight days after haemoglobinuria had ceased. Blackwater fever,

Case 7a.

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36. Section of medulla of kidney during suppression of. urine, eight days after haemoglobinuria had ceased. Blackwater fever, Case 7a.

37. Section of cortex of kidney during suppression of urine, five days after haemoglobinuria had ceased. Blackwater fever, Case 11. 38. Section of medulla of kidney during suppression of urine, five days after haemoglobinuria had ceased. Blackwater fever, Case II.

;. 39. Section of cortex of kidney during suppression