The hemorrhagic type of malarial fever, while fortunately infrequent, is nevertheless a most serious disease. The overwhelming production of, and intoxication by, the malarial organism, causes extreme hyperemia of the viscera, and partial disintegration of the blood. Hemorrhage most frequently comes from the kidneys alone, although it may appear from the several mucous membranes simultaneously. These are occasioned by blood, nutritional and pressure changes in the congested area. I doubt if anyone has lived long in a malarial district and countenances Dr. Koch's theory that quinin is the causative agent. I have seen four cases where no quinin was taken prior to the hemorrhage; one of these, a child, died the following day from suppression of urine.
The previous history of these cases presents the mild remittent or intermittent fever in most instances. We have no premonition of the occurrence of hematuria. Its appearance on urination after a chill, is