of sterilized water), sterilized, may be slowly introduced into the subcutaneous connective tissue of the flank or elsewhere by means of a hollow needle attached by a rubber tube to some improvised reservoir placed one or two feet above the level of the patient. The water is rapidly absorbed, and cannot fail to be useful in washing out the hæmoglobin infarcts which plug the renal tubules and bring about, or at all events contribute to, suppression of urine. Marked restlessness may require minute doses of morphia (1/10 gr.); but this drug, of great use at times, must be employed with caution. This is the only rational and safe systematic treatment of hæmoglobinuric fever. Antipyretic drugs, as antipyrin and phenacetin, are dangerous.
Sternberg's mixture of bichloride of mercury and sodium bicarbonate (p. 268) has come into favour lately, especially in Central Africa.
Calomel in large doses— 20 to 30 gr. is with some a favourite remedy for hæmoglobinuric fever. Formerly it was used systematically in Africa in these cases. I have heard of its being given there by the teaspoonful. I know of cases which recovered perfectly without a grain of calomel or of quinine. Severe stomatitis may arise from the former; it should therefore be employed with great caution, and in reasonable dose.
Quennec has advocated the administration, of small doses of chloroform in hæmoglobinuric fever. His formula is chloroform 4 grin., powdered gum q.s., sweetened water 250 c.c.: of this a tablespoonful is given every ten minutes until a certain degree of chloroform intoxication is produced. Thereafter the effect is kept up by enemata of chloral. In twenty-two successive cases Quennec had no death.
Tannic acid is another drug which enjoys a certain reputation in the treatment of malarial fevers that have resisted quinine, and also in hæmoglobinuric fever. It is given, well diluted, in 15-gr. doses every two hours for four or five times, the dosing being repeated on the third and sixth days to the extent of two doses each day.
