208 Captain H. S. Ranken. Treatment of Human [Dec. 23, 



condition on arrival at the Camp was alarming, and he was quite unable to 

 walk. A. full course of antimony, in doses of 1 gr., was successfully given 

 and there was a great improvement in his condition. The large masses of 

 glands were very greatly reduced in size. The tremor was unaffected, but he 

 became much stronger. He was able to act as a " native assistant " in the 

 laboratory and a " headman " in the camp. His improvement was maintained 

 for three and a-half months, when suddenly he relapsed and became a third 

 stage case. Blood examinations have been negative. The cerebro-spinal 

 fluid was examined also and the cellular elements were increased, but 

 trypanosomes were not found. 



In four other cases trypanosomes have reappeared in the blood. Two of 

 these were very susceptible to antimony and were unable to take doses at 

 shorter intervals than a week. After the relapse attempts were made to 

 give them another course of antimony, but it had to be given up owing to 

 their unusual susceptibility to the drug. The other two had heavy infec- 

 tions, but did not seem to improve. They have all been transferred to atoxyl. 



(d) The other 24 cases have shown improvement. In three it is slight 

 and these are being kept under close observation. In some cases the 

 improvement has been very striking ; in others who were admitted in fairly 

 good condition, it has not been so evident, but the whole appearance of the 

 patients is different. After a course of antimony there is not uncommonly 

 depression and debility. This, however, passes off in a few days ; the patient 

 becomes more active, feels and looks better, and loses the languor that is so 

 often seen in patients just admitted. They put on weight and the skin 

 becomes healthier ; this is no doubt due in part to the regular feeding in the 

 sleeping sickness camp, but the improvement would not occur were it not 

 initiated by the treatment. In some cases the tongue tremor has disappeared 

 under treatment. Probably some other cases will relapse, so these cases are 

 being kept without further treatment at present, as it is desirable to test the 

 effect of this treatment with antimony alone. 



II. Antimony and Salvarsan. 



Ten cases have been treated with these two drugs, but a regular course has 

 not been carried out ; the salvarsan was given, in the majority of cases, when 

 a patient was unable to take a complete course of antimony. 



No information has been obtained as to the best line of treatment to be 

 followed with this combination of drugs, but a further series has been com- 

 menced. 



The results up to the present are : Eight out of the ten cases are very well 

 and have shown definite improvement ; one deserted, but was in very good 



