6 THOMPSON YATES AND JOHNSTON LABORATORIES REPORT 
October 9. White rat (Experiment 21) inoculated intraperitoneally with 
4 can. blood ; never infected. 
October a. White rat (Experiment 22) inoculated subcutaneously with 
8 c.cm. blood ; infected October 23. 
October 9. White rat (Experiment 23) inoculated intraperitoneally with 
5 c.cm. blood ; infected October 23. 
Case IV 
Simple Trypanosomiasis (' Mala die de Button') 1 , September 22. — J. P., male, 
aged twenty-eight, native of Sierra Leone, where sleeping sickness is not endemic. ■ 
Came to Boma six years ago as a Free State soldier. Has always been in lower river 
districts. Entered hospital September 22 with gunshot wound. Had gonorrhoea 
in 1902, otherwise has not been ill during his stay in the Congo. 
Patient is a strong, healthy man, well nourished, skin moist and clean ; slight 
oedema over both shins ; patient does not complain of feeling ill. 
Glands are easily palpable, but are not markedly enlarged or hard. He is a 
brioht, intelligent man, slightly deaf, but answers questions quickly and well. He is 
alert and interested in his surroundings. Mucous membranes are anaemic. There 
is a complete cataract of right eye. Heart and lungs are normal. Liver normal in 
size, but slightly tender. Spleen normal. Appetite good. Bowels constipated. 
Nervous system is normal. 
Urine passed in twenty-four hours, 760 c.cm. ; specific gravity, 1,002, light 
straw colour, cloudy precipitate, acid ; small amount of albumen present, no sugar ; 
urea, 0-41 gram to 100 c.cm. of urine. Microscopically a few pus cells, probably 
due to a chronic gonorrhoea, were seen. 
On October 26, 10 c.cm. of limpid cerebro-spinal fluid, as clear as distilled water, 
were withdrawn with some difficulty by lumbar puncture. The patient almost 
fainted before 8 c.cm. had been withdrawn. A very slight percipitate was obtained 
after long centrifuging. On examination it was found to contain a very few red cells, 
and still fewer small mononuclear white cells. No trypanosomes were seen during a 
long and careful search of the whole of the precipitate. 
The cerebro-spinal fluid from this case presented a very different appearance, 
both macroscopically and microscopically, from that obtained from sleeping sickness 
cases. The fluid was clear, not clouded. None of the large mononuclear or smaller 
mononuclear and polymorphonuclear leucocytes seen in sleeping sickness cases were 
present. 
The accompanying chart shows the course of the temperature in this case, and 
indicates the occasions on which trypanosomes were seen in the peripheral blood. 
