Africa : blackwater fever in the tropical African dependencies : reports for 1913.

Date:
1915
Catalogue details

Licence: Public Domain Mark

Credit: Africa : blackwater fever in the tropical African dependencies : reports for 1913. Source: Wellcome Collection.

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    Jaundice was apparent on the second day of the disease and lasted for about five days after temperature had become normal—thirteen days in all. Hemoglobinuria lasted five to six days. | Albuminuria lasted for twelve days. Duration of disease —Twelve to thirteen days. Result.—Recovery. History of attack—On May 1st patient says he felt perfectly well in the morning, doing his work as usual, but on coming home in the middle of the day noticed that he felt no appetite for his food. During the afternoon he suffered from headache and a touch of fever, and before going to bed he took 10 grains of quinine sulphate. Patient passed a very bad night owing to severe headache and feeling of nausea. Second day.—Patient noticed on passing his water that it was “almost black,” and in the course of the morning his wife noticed that his eyes were yellow-looking. T saw the patient for first time about 6.30 p.m., when jaundice was very noticeable. ‘The temperature was 103°4° and the pulse 115. There was tenderness on light pressure over the hepatic region, marked pain and tenderness over the epigastrium, and he complained of persistent feeling of nausea, with occasional vomiting of “bile”’ There was no tenderness, either then or subsequently, over the region of the kidneys. Urine was passed freely throughout the illness and in normal quantities. Third day—The morning temperature was 102°8°, and evening temperature 103°, with a small pulse of 120. Jaundice very pronounced, and urine typical. The vomiting and epigastric pain was worse, large quantities of a clear bilious- looking fluid being brought up independently of food being taken. Only teaspoonful feeds of champagne, chicken broth, &c., could be retained. Mental condition clear. Fourth day—The morning temperature was 101° and evening teniperature 102°, pulse in each case 115. Skin was moist, and other symptoms remained the same. Patient passed a better night after one-sixth grain of morphia. Fifth day—Temperature 99°4° and pulse 97. Jaundice clearing up, and urine lighter in colour. Epigastric pain and vomiting also better. Siath day—The improvement in all the symptoms continued, and from this time the patient’s condition improved rapidly, and he made eventually a complete recovery with no relapse. Treatment.—Consisted of five grains of calomel the second night. Enema was used subsequently. Hot dry applications to the loins, saline injections (rectal). Mustard plasters to epigastrium, &c. No quinine was given. (b) Previous movements of patient—During the five and a half months of his present tour patient has lived entirely at the plantation with the exception of a short visit to Accra and Mangoase about six weeks before the onset of the disease. (c) Nil. T. A. Dowse, Medical Officer. ce CASE 5. (Vide also Casr 18.) REPORT ON A CASE OF BLACKWATER FEVER AT CAPE COAST. (Non-official), age 33. I. Previous illness. Lues three years ago. Blackwater four years ago when travelling home to England after invaliding for remittent malaria. Malaria, constant attacks. Il. Previous movements.— Has been in Cape Coast for seven months past. Bungalow away from town, but office is in middle of town, and surrounded by native shops and houses. History.—Patient had taken very little quinine for some months, and that spasmodically, when he felt slight attacks of fever. On Tuesday, 6th instant, he had an attack. of fever, with vomiting (six times). No headache. ‘ Bowels costive. On Wednesday he felt better, and vomiting was less | _. He went to the office.on Thursday, and on Friday afternoon the fever started at midday, with vomiting in evening. This continued till Sunday afternoon, 11th, when he sent for Medical Officer. Headache during this period, and bowels well opened by some purgative pills. !