Malarial haemoglobinuric fever (so-called), blackwater fever of the Gold Coast, chiefly from a clinico-pathological standpoint : with illustrative cases / by B.W. Quartey-Papafio.

  • Quartey-Papafio, B.W.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Malarial haemoglobinuric fever (so-called), blackwater fever of the Gold Coast, chiefly from a clinico-pathological standpoint : with illustrative cases / by B.W. Quartey-Papafio. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    complication, nor bile nor sugar. In one of Dr. Easmon’s10 cases we read the following remarks on the examination of the urine : “ Specimens of the urine were forwarded to Professor Binger and Dr. Wickham Legg, of London, but neither of these physicians—and one of them, the latter, is a specialist on the subject—was able to detect bile; on the contrary, the microscope and spectroscope revealed the presence of reduced blood.” 3. With regard to Symptoms referable to the Nervous System :—The most noticeable is the depression of the nervous force and vital energy ; malaise, weariness, aching pains in the bones and joints and back, shifting muscular pains, headache, periodical attacks of rigors, with shiverings, restlessness, dizziness, impairment of the power of the mental faculties in the form of a dull and clouded intellect, a mind wandering strangely— light-headed ; there may be hallucinations of sight and hearing, a low, muttering delirium gradually passing into a comatose stupor. Sometimes the delirium is acute, violent, and noisy ; voice is tremulous and there are muscular tremors, subsultus tendinum, carphology, and occasionally, but very rarely, there may be convulsions. From day to day the fever progresses and all the symptoms increase in their severity ; there are more severe pains in head and loins ; yellowness of the skin and conjunotivae deepened ; urine more scanty or absolute suppression, when examined now may show increased albumen about one-half; faeces are scanty, black, hard, and “ shotty ” lumps ; rigors severe ; temperature is now 105° F. or 106° F., pulse very weak and running; head symptoms increase and severe; and the scene is quickly closed, if the case is to terminate fatally—in comatose hyperpyrexia or uraemic suppression. In a typical case the whole scene occupies the space of seven days, or a bad case may go on to a much later date, and the patient then dies from exhaustion. Death at times takes place speedily in three or four days. The haemoglobinuria usually appears on the third or fourth day after the onset of prodromal symptoms, or it may be sudden, and then ceases on the third or fourth day after its onset—though there have been cases in which haemoglobinuria has gone on till the seventh day, and sometimes never ceases before death supervenes. With the cessation of haemoglobinuria there is often defervescence in the temperature and an abatement of general symptoms; the patient is thus relieved and passes into convalescence. Oftener than not, however, there is a deceitful remission before the manifestation of fatal symptoms. When this unfortunate phenomenon occurs every care and watchfulness have to be exercised in the attempt to save the patient’s life. Pathology.—As to the organism which produces the morbid changes in this as well as in the other variety of Malarial Fever, a controversy still continues. But I believe it is generally admitted that in all cases of Malarial Fever, of which Malarial Hsemoglobinuric Fever is only a type, a germ—Bacillus Malarias—is found in the blood of patients both during life and after death. I am aware of the opposition to this view led by Surgeon- [186080] 10 Easmon : Op. Cit., case of S., p. 22.