Salicylate of soda, boric acid, chloride of calcium, potash, preparations of Beereana, are used by some medical men in West Africa at the present time, and, it is said, as of many other drugs, with good results.
Transfusion of blood has been successfully practised in high degrees of anæmia in some cases. Oxygen inhalations are indicated, but are rarely available. Intravenous injection of normal saline, of hypertonic saline, of neo-salvarsan, have each in certain cases been followed by recovery. Burkitt, finding acetone in the urine, has had good results from an active alkaline treatment with potassium and sodium bicarbonate and calcium chloride.
In desperate cases of suppression of urine, Stannus suggests, and has practised with temporary success in one case, incision of the kidney; Sorel has employed intravenous injection of isotonic solution of sugar in six cases with success.
Nursing is. a most important element in the man-agement of blackwater fever. If the stomach will retain food this should be given in a bland and fluid form, but there should be no attempt to force feeding, especially with rich and indigestible viands. One precaution against syncope must be sedulously enforced: the patient must not be allowed to sit up, much less to get out of bed, until food has been retained and assimilated, and the risk of sudden death from syncope has passed.
If possible, the subject of a hæmoglobinuric attack should quit the endemic area, and never return to it, or to any malarial locality; a severe attack, or a second attack, implying as they would special liability, should be regarded as imperative indications to this effect.
Prophylaxis.— All depressing and predisposing causes must be carefully avoided, more especially chill, fatigue, and malaria, and also irregular dosing with quinine. In blackwater regions those who are the subjects of malarial infection should take quinine systematically, never irregularly, and should be especially careful to continue its use, in the accustomed doses and at the accustomed intervals,
