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

  • 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.

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    III. Personal History.— {a) Has not been known to suffer from any other serious disease, but has fre- quently had malaria, the last attack being last month, when he was placed on the sick list from August 1st to August 6th, 1913. He only took quinine when he had fever. He always slept under a mosquito net. (&) A native of Cape Coast, but has been stationed at Sekondi for many years. He went on leave to Cape Coast at the beginning of the year, and returned to duty at Sekondi in March. He lived in a good house in a very clean part of the town. I believe he was temperate in his habits. {a) Microscopical examination of the blood (by Dr. Hanschell) made on the fourth day of the disease directly after the patient reported sick. With the exception of occasional attacks of malaria he has not been known suffering from any serious disease previously. He was on the sick list from August 1st to August 6th with benign tertian malaria. He made a good recovery and returned to duty quite well. Present history.—On the 8th September he felt ill with headache and shivering, and did not go to his office. That evening his urine became black in colour and scanty in amount. He continued to be ill, and on the 11th September he reported to me in writing that he had fever and was too ill to come to hospital. I sent the hammock for him, and met him on his arrival at hospital at about 11.30 a.m. His temperature was 99'8° F. Pulse 126 and ver}^ weak. Liver and spleen were both greatly enlarged; his coniunctivse were deeply jaundiced. He passed a little dark-coloured urine after admission and again in the evening. The treatment adopted was a modification of Hearsey's. The patient rapidly became weaker, and died at 10.40 p.m.. on the same day. It was unfortunate that the deceased did not report his illness until the fourth day of his disease. A post-mortem examination was made on the morning of the 12th September. I attach the post-mortem report. I am indebted to Dr. Hanschell for the following report upon the patient's blood and urine. Blood.— Differential count (300 counted) :— Per cent. Polymorphonuclears ... ... ... ... 77 Lymphocytes ... ... ... ... ... 10 Mononuclears ... ... ... ... ... 13 Eosinophiles ... ... ... •.. ••• Nil. Very scanty subtertian rings were found. Total red blood corpuscles, 600,000. Total white blood corpuscles, 22,500. No pigmented leucocytes were seen, but six nucleated red corpuscles A thick blood film showed Filaria bancrofti. Urine.—Specific gravity, 1,017. Albumen present. Slight trace of bile. Alkaline methaemoglobin (revealed by spectroscopic examination). Haemoglobin index, 25 per cent. The small number of red blood corpuscles made life ]iractically impossible. Post-mortem Remarks upon Case 12. Thorax.—The heart was normal in size and revealed no traces of organic disease except a little commencing atheroma of the first part of the thoracic aorta. There was very little fluid in the pericardium, a little blood in the left side of the heart, and practically none in the right side. The blood present was extremely thin and watery in all the vessels. Both lungs showed old pleuritic adhesions; this was more marked on the right side than the left.