Transfusion of blackwater fever blood into a normal individual during haemolytic crisis

Abstract

From the transfusion of blackwater fever blood into a normal healthy adult with a previous history of malaria, it would appear that there are no specific parasites or haemolytic strains of malaria concerned in the genesis of blackwater fever, since the recipient of haemolysing blackwater fever blood failed to develop blackwater fever, or any other sign of haemolysis, although he went down with malignant tertian malaria 11 days after he received the blackwater fever blood. The possibility of his having been infected from other sources was absolutely excluded. The fact that the man failed to show any sign of haemolysis, although haemolysins were present in the blood he received, may have been due to the fact that he received insufficient blood; or that he dealt with any haemolysin he received immediately. Blood cells transfused from three normal individuals into a haemolysing case of blackwater fever underwent rapid haemolysis, showing that the red cells of normal individuals are just as susceptible to haemolysis when transfused into blackwater fever patients, as are the blackwater patient's own cells. This fact seems to us to dispose of the view sometimes put forward that the red blood cells of blackwater fever patients are more susceptible to haemolysis than are normal cells, and makes it appear probable that a circulating haemolysin may be responsible for the trouble. Of course it is by no means improbable that continuous sensitization is necessary before the red cells become liable to haemolysis, or infection over long periods with a special strain of malaria, and that one infection is not sufficient to sensitize the individual. Transfusion, even in moribound cases with red cell counts as low as 800,000 per c.mm., is a life-saving measure, provided that renal function is being maintained.