STUDIES OF MALARIA IN PANAMA. II. TREATMENT OF BLACKWATER FEVER

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Abstract
"Blackwater fever" is a term commonly used to designate fever with hemoglobinuria, associated more or less definitely with malaria. It embraces, I believe, two types of hemoglobinuria, which should be clearly differentiated for purposes of treatment and of study. The first type is associated with enormous numbers of malarial organisms, and, like the hemoglobinuria of piroplasmosis, its intensity is in direct relation to the severity of the infection. The mechanism of its production is, I am led to believe, the immediate destruction of erythrocytes by segmenting parasites, and differs from the mechanism of the second type, which is due, it is generally conceded, to the solution of erythrocytes by an unknown hemolysin (erythrolysis). I venture to propose, therefore, that the terms "blackwater fever," "malarial hemoglobinuria," "hemoglobinuric fever," etc., be abandoned as leading to confusion and possibly to grave errors in treatment, and that the two types of hemoglobinuria be

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