TRYPANOSOMIASIS EXPEDITION TO THE CONGO 93 
Throat : Tonsils not enlarged, no redness. 
Generative system : Menstruation regular, flow normal in amount, generally 
slight temperature on first day. 
Urine. April 29. Twenty-four hours specimen (preserved with thymol), volume 
1,100 c.cm. ; acid, color normal ; cloudy precipitate, Sp. Gr. 1,020 (8 2° F.) ; no 
albumen or sugar ; urea, 1-85 grammes to 100 c.cm. urine. 
April 30. Twenty-four hours specimen, volume 1,740 cans. ; color, normal ; 
acid, no albumin or blood ; urea, 1*55 grammes to 100 corns, urine. 
Faeces. Careful examination showed no signs of intestinal parasites. 
Liquor arsenicalis five drops three times a day was prescribed, and the patient 
was directed to increase the dose by one drop every third day. This treatment was 
followed until the 3rd of June (twenty drops t.i.d), when symptoms of saturation 
were evident, and this drug was discontinued tor a time and iron and arsenic pills 
were substituted. 
During 1895-96-97 quinine, grains V, was taken daily as a prophylactic against 
malaria. Its use was discontinued as it was thought to be the cause of ' neuralgia.' 
From January, 1903, to the present about three grains have been daily taken. 
April 21. Slight epistaxis ; bleeding at the nose had occurred on three previous 
occasions, once in Switzerland, twice in Africa, always slight. 
May 22. For past three days has had swollen wrists, first one then the other ; 
to-day one side of face is swollen, no redness or tenderness, or evidence of insect bite ; 
these swellings are fugitive, and last only for a day. 
June 2. For last few days patient has complained of lack of appetite and loss of 
energy ; the swellings on face and hands persist ; a papular eruption has appeared on 
the chest. 
The accompanying chart shews the type of temperature and the result of exam- 
inations for parasites during the first three weeks of our observations. On the 15th 
of April the parasites disappeared from the peripheral blood, and the temperature fell 
to normal. In spite of daily examinations of coverslips and periodic centrif ugalization 
of blood, trypanosomes have not been again seen. The temperature (with one 
slight exception) has, during this period, always been normal. 
Until signs of arsenical saturation commenced to show themselves the patient felt 
'much better'; she felt stronger and was less easily fatigued. There has been a 
slight increase in body weight, and in the value of erythrocyte and haemoglobin 
estimations. 
May 12 May 27 
Haemoglobin, 68 per cent. 74 per cent. 
Red Cells, 4,5 10,000 4,450,000 
White Cells, 4,650 4,000 
We have never seen malarial parasites in this case. 
