66 THOMPSON YATES AND JOHNSTON LABORATORIES REPORT 
In studying the column in Table I, in which is enumerated the number of days 
intervening between the puncture and the date of death, it will be seen that the 
probability of trypanosomes being found in the cerebro-spinal fluid tends to increase 
as one nears the fatal termination. This is shown by the following two Tables 
compiled from the forty-nine cases under analysis. 
Table III 
Thirty-five cases known to have proved fatal at the date of compilation of Table I 
Days before Death 
Number of 
Trypanosomes 
Trypanosomes 
Punctures 
present 
absent 
Within ten days 
27 
1 + 
•3 
Between ten and thirty 
'9 
8 
11 
Between thirty and one hundred and ten ... 
1 1 
+ 
7 
Totals 
57 
26 
31 
Table IV 
Fourteen cases not known to be fatal at the time of compilation of Table I 
Days before Death 
No. of Punctures 
Trypanosomes 
present 
Trypanosomes 
absent 
The majorit)' are comparatively early 
cases, and presumably man}- days from 
death 
17 
6 
A larger series of lumbar punctures in the earlier stages would be of the greatest 
interest. 
In the Congo disease, as we have seen it, mainly at Leopoldville, there is an 
endless variety of types. In most cases sleep is absent, in some dulness and apathy 
are prominent, in others nervous symptoms and mania are conspicuous, while a 
proportion of cases have only progressive emaciation and fever. In classifying these 
symptoms it does not seem possible to definitely connect them with the appearance 
or non-appearance of trypanosomes in the cerebro-spinal fluid. 
Cases 8 and 17, each of them punctured several times with negative results, 
except in one instance, were conspicuous for general absence of all symptoms except 
fever and emaciation. They each were able to walk and retain their faculties up to 
the time of death. Case 13 is in many respects similar to the foregoing two, but 
developed increased drowsiness some time before death, although showing no parasites 
in the cerebro-spinal fluid. 
