1910.] Sickness studied by Precise Enumerative Methods. 198 
dose of 4 grains at the commencement of a natural rise. The blood was 
examined every two hours afterwards and showed that the trypanosomes 
were increasing in numbers. Twenty-four hours later there was a further 
marked increase. Next day again, as we would have expected to occur 
naturally, there was a decided diminution in their number. 
On May 2 atoxyl was again given, though it was found that every dose 
ageravated the eye condition. From May 2 till June 20, 32 grains of atoxyl 
in all were administered at intervals, as noted on the chart. On comparing 
the graph where no atoxyl was given, and where it was administered, 
no yery appreciable difference in the number of trypanosomes can be 
detected. We cannot, however, conclude that the atoxyl has no trypanocidal 
effect, as had it not been given the trypanosomes may possibly have been 
much more numerous during the latter than in the earlier part of the chart; 
and further, this particular strain of trypanosome seems to have been very 
virulent. 
Our doses of atoxyl in any case were rather small. It would appear to 
us, however, that atoxyl cannot be considered a specific in human trypano- 
somiasis, aS quinine is in malaria. In our cases of malaria quinine never 
failed to diminish, markedly, the number of asexual parasites. Moreover, 
atoxyl compared with quinine is a dangerous drug. 
QUININE AND METHYLENE BLUE TREATMENT. 
Quinine 30 grains daily, combined with methylene blue, 12 grains daily, 
was administered by the mouth from February 21 till March 9, and again at 
other intervals as noted on the chart. No marked trypanocidal effect can 
be noticed. 
During treatment with these drugs, however, as also with atoxyl, the 
patient’s face, which had before been puffy and cedematous, especially about 
the eyelids, became more firm and clear cut. The eyelids became again 
cedematous soon after these drugs were withheld. 
It would seem, therefore, that quinine and methylene blue, as well as 
atoxyl, had some beneficial effect clinically. The following drugs were also 
given without apparent results :— 
(a) Trypsin and Amylopsin LInjections.—20 min. of each daily. 
(b) Succinamide of Mercury Injections.—One-fifth grain almost daily. 
(c) Jzai Oul.—8 min. daily, by mouth. 
(d) Trypan Ked.—By the mouth in doses of 0°5 grain, 1 grain, and 1 grain 
respectively on three successive days. No albuminuria resulted, but the drug 
was stopped on account of the development of severe vomiting. 
(e) Potassiwm Lodide-—30 grains daily, by mouth. 
Q 2 
