TRYPANOSOMIASIS EXPEDITION TO THE CONGO 91 
unfailingly, by baths. For the next three months, weekly fever. First day, tempera- 
ture about normal ; second day, slight fever ; third day, marked temperature ; fourth 
day, 'always just one degree higher than third day ' — highest temperature recorded, 
104/6 0 F. — fifth and sixth days, temperature much lower ; seventh day, 'about normal.' 
From January to April, 1902, the temperature ranged between 99 0 and 100 F., and 
was never normal. 
In January, and again in February her eyes, particularly the left, were ' inflamed,' 
and five days were 'spent with bandaged eyes in a darkened room. At the end of 
February, and during March, while on her way from her station to the sea-coast, four 
more attacks of fever occurred — temperature rising to I02°-I03°F. During the 
voyage to England, where she arrived at the end of April, 1902, the patient's tempera- 
ture gradually fell to normal. She remained in Europe until August, 1903, and then 
again returned to Africa. While at home she, on two occasions, suffered from fever, 
rising to I03°F. ; quinine efficacious. During June, 1902, and again in January, 1903, 
her eyes were once more affected, and oculists were consulted. At various periods 
during her stay in Europe ' red patches ' as large as a ' half-crown piece,' lasting for 
three or four days, appeared on her legs ; they were tender, and the surrounding 
skin seemed hard. At one time patient's joints seemed stiff, at another she suffered 
from an 'inflamed throat. Three months were spent in Switzerland, the patient 
gained rapidly in health, and on leaving for Congo, August, 1903, seemed well, and 
weighed 145 lbs. Her medical history from her last arrival at the Congo to April, 
1904, when we first saw her, is as follows : — 
' October 10, 1903. Fever on the river steamer ; lasted for two days ; maximum, 
I02°F. 
' November 9. Still on steamer ; temperature suddenly rose to 105° F., reduced by 
bath ; throat bad next day, relieved by gargling ; discharge of matter for two days. 
On Tuesday, November 10, Wednesday, and Thursday, slight fever. Friday, 13, 
5 a.m., I05°F., bath; 10 a.m., io5°F., bath; 1 p.m., io5°F., bath; 3.30 p.m., 
107° F., bath; 8 p.m., 105° P\, bath ; the temperature fell to about ioi°F. after 
each bath ; patient delirious.' 
' November 14. Patient too weak to walk, was carried from the steamer; 
highest temperature, IG2°F. At 2.30 on the morning of the 15th the tempera- 
ture rose to 1 05° F., a bath was given, and temperature brought down. On 
the 1 6th the temperature was ioo°F., and on the 1 8th normal. There was no more 
fever until March, 1904.' 
For two or three weeks she was apparently quite well. About Christmas, 1903, 
severe headaches commenced ; about the middle of January these began to be accom- 
panied by vomiting. At first the vomiting and headache ' appeared at irregular 
intervals, later as follows : — ' First day, comparatively well ; second day, malaise 
with slight headache ; third day, bad headache, vomiting two to six times (on one 
