1910.] Sickness studied by Precise Enumerative Methods. 189 
our patient they were capable of dividing and sub-dividing three to four 
times in 24 hours. : . 
The natural fall is even more sudden than the rise. On April 29 the 
parasites fell from 1536 to 100 per cubic millimetre of blood in 24 hours. 
Except on April 5 and 6 only one observation was made daily, so that 
obviously we may have missed the highest points reached in the various 
rises. The low levels were, as a rule, maintained for three or four days, 
forming U-shaped bends as recorded in the chart. The lowest number recorded 
was 8 per cubic millimetre of blood, while the highest reached 1536 per 
cubic millimetre of blood. 
It is worthy of note that there is a tendency for a high rise to be followed 
by a low one. This is not without exception, but the three highest rises 
recorded were followed by the three lowest rises. 
(3) Correlation between the Cycle and the Amount of Fever. 
From the chart one can observe that almost invariably the temperature 
tends to be higher during the height of the cycle, and that between the rises 
the temperature keeps lower. 
In the table average daily temperatures are recorded. These figures were 
obtained by taking the average of the four-hourly temperatures observed during 
the 24 hours of each day. We think that this figure gives a fair representa- 
tion of the amount of fever for the day, and in this table it may be noted 
that the average daily temperature rises coincidently with the increase of 
trypanosomes and falls with their fall. 
(4) Other Clinical Observations and Correlations with the Cycle. 
The pulse rate ranged all through this case from 90 to 120 per minute. 
During the height of the cycle it tended to increase coincidently with the 
increased amount of fever. The respiration rate ranged from 20 to 28 per 
minute, tending also to increase with the rise of the trypanosomes. 
With regard to the bowels there is little to note. Their action was easily 
regulated with small doses of cascara. It was very noticeable that the 
patient was more drowsy, and tended to have headaches, during the com- 
mencement of the cyclical rise, but these symptoms abated at the extreme 
height and during the subsequent fall of trypanosomes. 
The lymphatic glands in the neck, axilla, groin, and popliteal space were 
more or less always swollen, but this condition was greatly aggravated at 
intervals, accompanied with marked tenderness, though only sometimes was 
this coincident with a trypanosome increase. 
