Blackwater fever in the tropical African dependencies : reports for 1912.

  • Great Britain. Parliament. House of Commons.
Date:
1914
Catalogue details

Licence: In copyright

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

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

    197/204 (page 95)
    1)5 The fireman of s.s. Rose and the Yonte taifor vvere twice saved by the injection of quinine, and then tJie fireman died under quinine injection treatment system. To my knowledge of fifteen years of Jubaland I know of these four cases of blackwater fever only, against thousands of malaria in every station in Jubaland from Kismayu to Serenli. Another point in this connection is that the natives of Jubaland do not seem to have any idea of this disease. In short, it must be a very very rare form of malaria, if it may be so, and should be very very severe, or a small minority of men is specially predisposed to it, or the germ wdiich produces it is rarely brought in contact with man. I believe blackwater fever is a disease of bush, long grass and dampness. In conclusion, I beg to state my views upon the treatment of the disease, on which, I think, much difference of opinion exists. I believe in the injections of quinine twice or thrice daily until the temperature is about normal. I cannot possibly understand why it should be contra-indicated. It cannot possibly be a food of any germ, though certainly a poison for many. Then it is a remarkable agent to keep the temperature down, to regulate the liver and to subdue malaria, which state must be ]3resent even taking it for granted that black- water fever is a non-malarial disease, as we have always found cases of blackwater fever in the regions with malaria all round. The second point, in my opinion, is of jaundice, which is also responsible for the presence of blood in urine or complete inaction of kidneys. To meet this a dose of white mixture every time after the patient vomits should be given until bowels move freely and frequently, and then 10 grains of sodium bicarbonate : in mixture in frequent doses until one drachm is kept in daily for three days. If this does not answer the purpose transfusion of saline mixture seems to me to be the onlj thing which should be jiractised on third day. Hot fomentations or dry cupping in the region of kidneys should not remain without trial. If cured of one attack the subject of blackwater fever should never stay in the vicinity of the place where he had contracted the disease, and he should never go and stay near the place where any case of blackwater fever is ever found. A country of a very dry or cold climate should be the country of his living. Imam Bakhsh, Sub-Assistant Surgeon. Case 14. Eldaina Rarine. Adult male, Indian. Pre pious History. Indefinite : patient \vAn been living in Uganda, and had there had previous attacks (number and date not known) of blackwater fever. He had taken quinine at intervals (quantity unknown). History of present illness. The patient had come from Uganda, and on his safari came into Eldama Ravine. At the onset of the attack the temperature rose to 104°, and reached 105° the same evening ; there was much pain in the limbs and head, and the patient vomited bile. On the first day the urine became pink, and soon turned to a dark brown. There was some jaundice, and the spleen was enlarged. Recovery took place and the urine recovered its normal colour in a week. Locality. Eldama Ravine station is situated on a small eminence among the Mau Hills. The station itself is fairly clear of vegetation, but there is cedar forest within a short distance. The river is about 300 feet below the station. There are no bad swamps in the vicinity. Occurrence of a series of cases. There have been no other in the district.