TRYPANOSOMIASIS EXPEDITION TO THE CONGO 41 
February 2. Is in better condition, and is brighter than when admitted ; abdomen 
distended ; oedema of loins marked. 
February 16. Shows no signs of sleep, walks now without any unsteadiness. 
Appetite large. 
February 24. Seems quite well ; slight oedema of shins, but none elsewhere ; 
no puffiness of face ; can walk about with ease. 
March 18. Gait normal, expression contented, no dulness, is quite intelligent, 
answers questions quickly and well; glands all enlarged, but femorals and inguinals 
apparently smaller than when admitted to hospital ; slight oedema of shins ; liver still 
enlarged, but not tender ; heart and lungs, normal ; knee jerks, normal ; epigastric 
and cremasteric reflexes obtainable ; appetite good ; no drowsiness ; patient works 
willingly around the hospital. 
April 1. Has certainly put on flesh lately and increased in general robustness. 
Symptoms Associated with the Presence of the Parasites 
in the Blood 
The only patient in whom a large increase of parasites was associated with a rise 
in temperature and the presence of symptoms which might be attributed to the 
parasite was Mokoko (Case 65), whose case is given above. 
From our observations we cannot make out any definite relation between the 
temperature and pulse and the appearance of the parasites in the peripheral circula- 
tion. A rise of temperature is not necessarily associated with an increase of parasites 
in the blood. 
It appears, therefore, that the number or constant presence of the parasites in 
the peripheral blood bears no relation to the severity of the disease. 
Occurrence of Parasites in Serous Fluids 
On two occasions 10 c.cm. of fluid was drawn from a flabby hydrocele (in Case 104) 
and centrifugalized. Parasites were seen each time, although they were absent from 
the blood to ordinary examination, and probably had been absent for some days 
previous to the second tapping. The cerebro-spinal fluid ot this case was also 
examined on the same date as the first tapping, but no parasites were seen, although 
the deposit of the centrifugalized hydrocele fluid showed fourteen to a cover. In 
another case (number 92), in which the penis and scrotum were very oedematous and 
there was a small right hydrocele, no parasites were seen in either oedema or hydrocele 
fluids, although the blood showed thirty to a cover. We have not found parasites 
in the urine (centrifugalized) in the few cases examined in which the blood showed 
many parasites. 
G 
