EOUTINB WOEK 173 



dead of that disease, has suggested that experimental work on similar lines might be tried in 

 the case of trypanosomiasis. In several particulars the two diseases are far from dissimilar. 

 Each exhibits a blood and glandular infection by a living organism, in each toxines are 

 produced, and there are other points of resemblance which need not be cited here. It is, 

 therefore, proposed to make some investigations in this direction. Preliminary experiments, 

 however, have not yielded any good results, and Herzog has rather upset the prevalent ideas 

 regarding the precise nature of plague (Journ. Trop. Med., 15th Feb., 1906). While dealing 

 with this subject I may say that I intend to test the value of the Malay fish poison 

 Dcrris dliptica as a therapeutic agent in trypanosomiasis. Daniels states that it is very 

 inimical to all low forms of life, while at the same it appears to be comparatively harmless 

 to man. It is therefore just possible that it might prove useful. 



Preventive methods on the lines indicated by Todd * and others will be required to 

 check the spread of Sleeping Sickness from the Congo Free State. 



Routine Work 



This has varied very much in amount. At times it bulked so largely that it was difficult 

 to cope with it properly ; at other times considerable intervals would elapse during which 

 very little had to be done. 



The number and nature of the examinations performed, and concerning whicli reports 

 were furnished, are herewith detailed. The period covered is one of fifteen montlis. 



A. Morbid secretions and e.xcretions 30 



B. Blood examinations ... ... ... ... ... ... ... 197 



C. Bacteriological apart from (A.) ... ... ... ,31 



D. Parasites apart from (A.) and (B.) ... ... 10 



E. New growths .. . ... ... ... ... ... ... ... 7 



P. Other pathological conditions ... ... 11 



G. Plant diseases 12 



The above figures do not by any means indicate all the cases which have come under 

 notice. In a considerable number, especially of the blood examinations, a verbal opinion has 

 been given, and these are not included. In several directions the value of having a central 

 place where examinations can be made has been shown, as in the case of glanders and 

 strangles in horses, in several cases of diphtheria, in malaria, and in suspected cases of 

 hydrophobia. 



Some notes on the cases listed may be given with advantage. Taking first infectious Smaiipox 

 disease, the accompanying photographs (Figs. 76 and 76 a) of a case of small-pox which came 

 under my care as Medical Officer of Health, exhiljit very well the appearance and distribution 

 uf the pustules. Their confluent condition is well shown upon the face. This case 

 contrasts admirably with the accompanying photographs (Figs. 77 and 78) of chickeu-po.x and 

 an ecthymatous secondary syphilitic rash. All these were taken by Mr. Newlovc. The 

 cases were under the care of Mr. Waterfield, and I am much indebted to him for his kind 

 permission to photograph them and reproduce the prints. The case of small-pox has a 

 further interest in that I made an effort to obtain from the pustules the protozoon discovered 

 and described by De Korte.f I found some amceba-like forms characterised by the possession 

 of the highly-refractile, greenish particles (spores f ) which he mentions. My efforts at 

 staining, however, were not satisfactory, and I was unable to carry my observations to any 



* Lancet, London, July 7th, 1906. 



t Brit. Med. Journ. London, Nov. 11, 1904, also Lancet, London, Dec. 24, 1904. 



