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June 23, 1923


JAMA. 1923;80(25):1847. doi:10.1001/jama.1923.26430520002010b

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I treated eleven cases of blackwater fever in 1918 in the republic of Panama. All of these patients were negro or a mixture of negro and Spanish, and ranged in age from 28 to 45 years. The temperatures ranged from 102 to 105 F. Severe headache, pain in the loins, vomiting, jaundice and insomnia were marked features, and estivo-autumnal malarial parasites were found in the blood of all patients.

My worst case was that of a young native physician, aged 32. When I was called in to see him, his temperature was 103, and he had a severe headache, pain in the loins, nausea and vomiting, with slight jaundice. Urine examination revealed a large amount of hemoglobin.

The treatment in all the cases consisted of dosages of quinin, calomel and coconut water. The calomel was given in 5 grain doses as soon as the patient was first visited, and before

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