266 
THOMPSON YATES LABORATORIES REPORT 
Kidney — Sections again shew fibroid changes in the thickened capsule of the organ, 
with a tendency to spread into the kidney substance. Some of Bowman's 
capsules are thickened — and there is some thickening of the arteries. The 
renal cells of the tubules are well defined — nuclei stain well — the proto- 
plasm has a slightly granular appearance, and in places there is a slight 
epithelial desquamation, with a granular deposit in the tubules. There is 
some congestion of the stellate veins and vessels of the boundary layer. No 
pigment present. 
Lung — Sections shew a condition of marked emphysema. Round some of the 
bronchi the alveoli are filled with a catarrhal exudation, and a few golden 
corpuscles are present. The bronchi shew catarrhal inflammatory changes. 
Brain — In sections of the cerebral cortex, and of the corpus striatum,* no patho- 
logical changes can at present be made out. No malarial pigment is present. 
The interesting features to be noted in the results of this examination are the absence of 
recent malarial pigment from the positions in which it is generally found in cases of malarial 
fever — and secondly, the absence of cloudy swelling of the parenchymatous epithelium of the 
organs, and of marked fatty degeneration such as one would naturally have expected as a result 
of a period of some four weeks' high temperature. It must be stated that the patient had been 
several years on the West Coast of Africa, and had had several attacks of malarial fever, thus 
accounting for the presence of a little old pigment. 
The absence of cloudy swelling and fatty degeneration changes in the organs points not 
only to the non-malarial nature of the disease but, we take it, also that a 'toxic' substance pro- 
duced in the course of a specific infective disease was also absent. It has been suggested that the 
characteristics of this disease — the peculiar absence of local symptoms, the manner in which 
the temperature is uninfluenced by drugs, but easily affected by cold applications, and the long 
period through which it gradually becomes normal, as well as the conditions found on pathological 
examination — might be all explained by some profound disturbance in the process of heat 
regulation. 
In this connection it may be pointed out, on the West Coast of Africa a temperature 
of about 130° F. and an atmospheric humidity of between 90 and 100 per cent, are 
often associated, and that these conditions have considerable influence on the health of 
Europeans in those parts — accounting for some few of those cases treated as malarial fever 
cases. From our own observations such cases occur, from which the typical signs and 
symptoms of malarial fever are absent. It has been noted that no cases of insolation, siriasis, 
sunstroke, sun or heat fever are found mentioned in the medical reports of Southern Nigeria. 
It was our experience at Old Calabar that the climatic conditions often produced a slight 
rise of temperature, and for experimental purposes we occasionally undertook rather severe 
exercise, such as hard walking (provided with sun helmet or shade) in the open, and almost 
invariably noted a rise of temperature after an hour or so, although perspiring profusely at 
the time. Temperatures reaching up to 1 02*2° F. were observed — normal being reached 
in the course of a few hours. It is easy to imagine that an exaggeration of such conditions, 
together with a constitutional condition in which from any cause the dissipation of the heat 
of the body does not balance the production might, perhaps, lead to such an overthrow of the 
process of heat regulation as to occasion conditions similar to those of the so-called 'hyperpyrexia!' 
fever cases described. 
'Further investigations in the pathological histology of the corpus striatum in this case are being undertaken. 
