4 THOMPSON YATES AND JOHNSTON LABORATORIES REPORT 
his attention engaged, no swaying or falling occurs even if the heels are together. At night he will sit 
quite motionless without trembling. He is fanciful in his wishes and tastes, and very quarrelsome with 
his companions. 
Respiratory system : Lungs normal ; expansion good. 
Circulatory system : Heart, normal size and position. Slight accentuation of pulmonary sound. Pulse 
variable, often markedly irregular, quick, without tone, and soft, at other times of high tension with a slow 
but regular rhythm. 
Digestive system : Teeth good ; faeces contain ova of Ankylostoma duode?iale. 
Liver not enlarged nor painful. 
Spleen moderately enlarged, not painful on palpation. 
Genito-urinaiy system : Urine normal, sp. gr. 1020. No albumen. No sugar. 
Analysis of Urine made by Mr. Edie, Laboratory for Bio-Chemistry 
Date 
Urine 
Sp. Gr. 
Gram 
Total 
Nitrogen 
Gram 
Urea 
Gram 
Uric Acid 
Gram 
NH, 
J line 1 7 
3 2 5 
IOI4 
Neutral 
3-14 
5-82 
• I I 
•05 
Albumen and Sugar 
absent 
Glandular system. All groups enlarged, especially right. Inguinal and left cervical freely moveable, 
not painful. 
Aural and nasal systems normal. 
Pupil not dilated. Reaction to accommodation and light normal. Small opacity on cornea of left 
eye about 1 mm. in diameter. 
Nervous system: Knee jerks increased. Cremasteric, epigastric, and anal reflexes not accentuated. 
Jaw clonus normal. Ankle clonus very accentuated at times. 
Electrical reaction of skin normal. Some of the peripheral nerves reacted very slowly to the 
galvanic and faradaic currents. Some evidenced the degeneration reaction. The majority reacted 
normally. 
From May 25 to June 11 the boy continued in the same state, seemed to gain in strength and 
became less excitable. The tremors became less accentuated and he learnt rapidly. At times he would 
become depressed and say he had 'manimba' and was going to die. Sleep symptoms were not noticed. 
During this period the parasites were always scanty, but appeared to be increasing on the 12th. On 
that day he finished his work and went to dinner ; at 2 p.m. the attendant came and said he could not 
wake him. He was found lying on his side with his knees drawn up, apparently asleep and perfectly 
motionless. On being shaken and shouted at he would open his eyes and utter a word and then 
relapse into the somnolent state. The temperature per rectum was 96^2 0 F. The cremasteric and 
epigastric reflexes normal, the anal much less. The knee jerk was much lessened. Respiration, 22, 
full and regular. Pulse, 100, soft, low tension, and irregular. After four hours he woke up and 
appeared to feel as usual, though somewhat dazed and unsteady in his gait. For the next two 
days he was kept in bed, but was always getting out and sitting on a chair. Parasites were increasing in 
numbers. The temperature continued sub-normal. On the 15th, 30 c.c. of cerebro-spinal fluid was 
drawn off by Dr. Christy without difficulty, the fluid welling out when the needle entered the canal. 
The clear fluid, not contaminated with blood, contained trypanosomes, as man}- as five to a field. The 
blood at this time contained 700 to a c_>ver, irregularly distributed, groups of two, four, and six being 
