Severe Hæmaturia Resulting from the Use of M.&B. 693

A female child, aged 6 years, was attacked with slight fever on the 2nd July, 1940. Her temperature came down to normal next day. But it rose to 102.5 ?F. at night and came down to 99?F. on the following day (4th July). Malignant tertian malaria parasites were found in the blood and 6 grains of quinine bihydrochloride were injected intramuscularly. Another injection of quinine was given in the same strength on the 5th July. But in spite of these injections the temperature was oscillating between 100?F. and 102.5?F. On the 7th and 8th July two more injections of quinine, 6 grains each, were administered. The fever did not yield. Bowels were constipated and moved by calomel and salts in the early stage. Later on, the child had occasional loose foul-smelling motions. Urine was very scanty during 24 hours. Pulse rate varied between 108 and 120 per minute. No abnormality was found in the lungs. Urine.?Reaction?acid. Chemical examination? phosphates present. Microscopical examination?pus cells, epithelial cells, organisms?Gram-negative bacilli (B. coli ?), diphtheroids, Gram-positive cocci in pairs and chains. Stool.?No evidence of dysentery or helminth infection. Progress.?The fever was irregular (99? to 102?F. axillary temperature). Ilexamine was tried for three consecutive days from 11th to 13th July, to disinfect the urine, but it did no good. Four tablets of M.&B. 693 were given daily from the 17th to the