Concord Hospital, and Department of Medicine, University of Sydney, Sydney, Australia.
J Nephrol. 2009 Nov-Dec;22 Suppl 14:120-8.
After several descriptions by Hippocrates and a single possible medieval description by Gilles de Corbeil, a severe febrile illness accompanied by the passage of dark urine burst upon the medical scene in West Africa in 1819, described by an English surgeon named Tidlie. Most of his patients died within a few days. Further reports appeared from tropical regions until the turn of the century, J. Farrell Easmon having given the condition the name blackwater fever in 1884. Controversy raged about its relationship to malaria, as well as over its treatment with cinchona bark and quinine. Evidence evolved that it was a complication of falciparum malaria in which hemoglobinuria causing acute renal failure resulted from massive quinine-induced lysis of red blood cells. People with red cell abnormalities such as glucose-6-phosphate dehydrogenase deficiency proved particularly prone to developing it. Its incidence fell as more mildly acting antimalarial drugs replaced quinine. Several enigmatic issues bedeviled understanding of it, but a careful analysis of its historical development has enabled resolution of each of these.
1819 年，在 Hippocrates 的几次描述和 Gilles de Corbeil 的一次可能的中世纪描述之后，一种伴有深色尿液的严重发热疾病突然出现在西非的医学领域，由一位名叫 Tidlie 的英国外科医生描述。他的大多数患者在几天内死亡。进一步的报告来自热带地区，直到世纪之交，J. Farrell Easmon 于 1884 年将该病命名为黑尿热。关于它与疟疾的关系以及用金鸡纳树皮和奎宁治疗该病的争议不断。有证据表明，它是恶性疟原虫疟疾的一种并发症，血红蛋白尿导致急性肾衰竭是由大量奎宁诱导的红细胞溶解引起的。葡萄糖-6-磷酸脱氢酶缺乏等红细胞异常的人尤其容易患上这种病。随着更温和的抗疟药物取代奎宁，其发病率下降。有几个神秘的问题困扰着对它的理解，但对其历史发展的仔细分析使这些问题都得到了解决。
