94 THOMPSON YATES AND JOHNSTON LABORATORIES REPORT 
' '"OH 
It was through the kindness of Mr. M., a missionary stationed at Leopoldville, 
and the husband of the case ' Mrs. M.,' described by Broden and Manson, that this 
case was brought to our notice. He felt convinced that he had, in October, 1903, 
seen an erythema on Mrs. G.'s forehead in every way similar to those which he had 
previously seen in each of the cases from the Congo described by Manson. 
We have been unfortunate in never seeing this case when erythemata were 
present. 
Case II 
T., a steamer captain, aet. twenty-eight, serving his first term in Congo. Patient 
left Antwerp, November 26, 1903, and arrived at Leopoldville, December 30. He 
reached his station, a wood post for steamers, on the banks of the Congo, just below 
its junction with the Kasai, on December 31, and remained there until April 13, 
1904, when he was invalided for 'fever' to Leopoldville. 
Here he came under the care of Dr. Grenade, the State Physician, who found 
that quinine was without effect, and, suspecting the nature of the patient's fever, 
very kindly allowed us to study the case. 
History. — Six years ago the patient spent eight to nine months in a cargo 
steamer plying between Sierra Leone and the Gold Coast ; the steamer often remained 
in various ports for some little time. In spite of this he never had ' fever,' and in 
1898 he returned to Europe. Since then, until leaving for the Congo, November, 
1903, he had been employed on vessels plying between European ports. After 
frequent questioning, the patient admitted that during this period he had had very 
occasional 'fevers' preceded by a 'cold feeling,' and followed by sweating. No quinine 
was ever taken for these ' fevers.' 
While on the East Coast of South America, during six months in 1894, he had 
yellow fever. 
In 1 90 1 he was in hospital for four or five weeks with rheumatism in legs and 
arms. With these exceptions, he has always had good health. 
Complains of constipation since leaving Europe. 
During his stay at the wood post he had five attacks of fever. The first com- 
menced January 26, 1904, about four weeks after he reached the post, and lasted to 
February 3 ; during nine days he was ill, maximum temperature, io6 , /°F. 
The second attack occurred on February 17 and 18, two days' duration, four- 
teen days interval between it and first fever. 
The third attack lasted two days, February 22 and 23, five days' interval between 
it and preceding fever. 
The fourth fever also lasted two days, March 9 and 10, interval sixteen days. 
During these last two fevers temperatures of I02 - 2°F. to I04°F. were 
recorded. 
