The war crimes trial of Slobodan Milosevic has been adjourned for the fifth time because of the former Yugoslav president's continuing ill health.

"The report has come from the detention unit that the accused has said he is tired and his blood pressure is described as being too high," residing judge Richard May told the court.

Last week there were also no hearings in the case as Mr Milosevic, aged 61, complained of exhaustion and fatigue.

The latest adjournment comes after Mr Milosevic on Monday rejected prosecutors' demands for him to be obliged to take a defence lawyer, in order to speed up proceedings.

He accused the prosecution of trying to stop him speaking and vowed to continue with his own defence.

Milosevic pale

Last week Judge May asked for the parties involved in the trial to make suggestions that would help to ensure that the trial is completed in reasonable time.

Judge May has imposed time limits on prosecution and defence

Judges ordered a medical report that is to focus on "the current state of health of the accused, when he is likely to be able to resume the trial and the prognosis as to his future fitness".

After extensive health checks earlier this year, doctors found Mr Milosevic was facing "severe cardio-vascular risks" and recommended shorter trial days.

The new system, designed to ease the workload the former Yugoslav president, began with the second part of the case, focusing on Bosnia and Croatia, started on 25 September.

Correspondents say Mr Milosevic looked pale in court on Monday, after a 10-day break.

He called the suggestion to appoint defence counsel "illegal and absurd" and threatened to take his case to the European Court of Justice if he was no longer allowed to defend himself.

He asked the judges to grant him provisional release, to give him time to read 200,000 pages of documentary evidence and listen to thousands of the prosecution's cassette tapes.

Influenza

Prosecutors argue that he is not entitled to defend himself; the tribunal statutes say that, while he has that right, he may also have legal assistance assigned to him in the interests of justice.

The judges said that the question is debatable under international law and they will need time to consider it.

The former Yugoslav leader has suffered several times from influenza, causing long adjournments in the trial, which began in February.

BBC legal affairs analyst Jon Silverman say that from the court's point of view the worst thing that could happen would be for Mr Milosevic to die, as it would then face accusations that it killed him.

Judge May has asked prosecutors to conclude their case by May for all alleged crimes, including those in Croatia and Bosnia.

Mr Milosevic is scheduled to begin his defence then.