On haemoglobin metabolism in malarial fever / by G.C.E. Simpson.

  • Simpson, G. C. E.
Date:
1910
Catalogue details

Licence: Public Domain Mark

Credit: On haemoglobin metabolism in malarial fever / by G.C.E. Simpson. Source: Wellcome Collection.

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    recorded, o'8 gram in scarlet fever, 2°02 gram in perityphlitis and 2 grams in malaria. After trials of various methods, the method of quantitative determination adopted for the purpose of this work was to determine the dilution of the urine required to just render invisible the spectruin of urobilin, when examined by a spectroscope in a layer of 15 mm. thick. The spectroscope was standardised with solutions of purified urobilin, and the readings appear to be reasonably accurate except that, when only a low concentration of urobilin is present, they are too low. The spectroscopic results were checked in many instances by the more delicate fluorescence tests. By this method I failed after repeated trials to find urobilin in any specimen of urine from healthy adults; amounts varying from 0'04 to 0°25 grams per diem were found in various pyrexial diseases and from o’02 to 0'06 gram per diem in cases of anaemia, inter- muscular haemorrhage and hepatic disease. In a case of Malta fever (temp. 104° F.) and in a case of acute suppurative hepatitis (probably dysenteric) (temp. 104° F.) 0'3 and 0°31 gram per diem were found respectively. (5) In five cases of semfple tertzan malaria (P. vivax) the amount of urobilin found in the urine in the period of pyrexia and the days following was never greater than the average excretion in diseases such as pneumonia with an equal degree of pyrexia, and in Case 3, indeed, was scarcely perceptibly increased from the normal limits :— Maximal excretion in twenty-four hours (Case 4) o'19 gram. Maximal total excretion in seven days after pyrexia (Case 4) 0°42 gram. (c) In malignant terttan malaria (P. falciparum) a different picture is obtained; definite urobilinuria sets in very shortly after the onset of the pyrexia, reaches its height on the second or third day and then slowly diminishes; the normal level of excretion is reached in seven to ten days unless a fresh paroxysm intervenes. Sometimes the increased output continues for a longer period (e.g., Case 20), and in old standing cases with chronic malarial anaemia there may be a continuous raised urobilin output even in the absence of pyrexia (Case 19); and in these cases marked haematoporphyrinuria was several times noted (Cases 17, 18, 19). (Haematoporphyrinuria was also noted on one occasion in Cases 20 and-23.) U
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