TRYPANOSOMES, TRYPANOSOMIASIS, AND SLEEPING SICKNESS 51 
It is the only remedy at present giving any prospects of a cure. In the 
treatment of cases a rational method of treatment must be adopted. It is useless, 
for instance, to only administer arsensic lor a short period or until the parasites have 
apparently disappeared from the peripheral circulation. The drug must be 
administered in as high doses as possible, and it must be continued even after all the 
favourable signs are present, viz., disappearance of parasites from the blood ; increase 
of weight, improvement in the blood count and percentage of haemoglobin ; loss or 
the autoagglutination phenomenon of the blood corpuscles ; decrease in and more 
regular temperature. From time to time susceptible animals ought to be inoculated 
with large quantities of the patient's blood at least in amounts of 5-0 to 1 5-0 c.c. At 
the same time all aids in building up the physical condition of the individual should 
be used. If such a regime be carried out, and treatment be begun at an early period, 
the prognosis (based on the experience of treated animals) will be good. 
With animals, on the other hand, the question whether treatment with arsenic 
is indicated calls for some consideration as Laveran and Mesnil, Bruce, and others 
have pointed out that there is some danger of treated animals becoming a source of 
infection, by filling the position in these diseases occupied by the native in 
malaria. The arsenical treatment will cause a temporary disappearance of the 
parasites from the blood. Some animals may entirely recover, but the majority suffer 
a relapse, and these latter are then a source of infection for the surrounding country. 
On the publication of Ehrlich and Shiga's results in the treatment by trypanroth 
of rats infected with T. equhium, some of the dye was procured and a series of 
comparison experiments was made. The results coincide with the findings of the 
other workers. It is not a very safe drug. Ulceration is very apt to occur, the 
sloughing is often extensive and persistent. The tendency to cause nephritis is 
marked and hence its use, when continued, with arsenic is often apt to lead to fatal 
results, especially in guinea-pigs. High doses of the dye must be employed, and on 
account of its chemiotoxic properties intramuscular administration is the best method. 
Very otten animals injected with large quantities of the dye appear to be in a stuporose 
condition which may wear off or persist up to death. Shortly after the injection of 
trypanroth the tissues commence to turn a bright red colour, and the secretions, 
urine, etc., are stained. The staining persists for a very long time ; the internal 
organs may show the staining of the dye for eight weeks or more after injection. 
We cannot claim to have cured any animal infected with the parasites of Surra, Nagana, 
Dourine ; the disease, especially in rats and mice, may be greatly prolonged, but the 
animals eventually die. Larger animals, especially dogs, cats, and monkeys, frequently 
show toxic symptoms with small doses. On the other hand, a bitch injected sub- 
cutaneously with fifteen to twenty c.c. of one per cent, trypanroth two and three 
times a week showed very little toxic symptoms besides a somnolent condition which 
lasted for about eight hours after each injection. The combination of trypanroth and 
