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GLAND PUNCTURE IN TRYPANOSOMIASIS* 
COMPARED WITH OTHER METHODS OF DEMONSTRATING THE 
PRESENCE OF THE PARASITE 
FOURTH INTERIM REPORT 
From the Expedition of the Liverpool School of Tropical Medicine to 
the Congo, 1903 
BY THE LATE 
J. EVERETT DUTTON, M.B. Vict. 
WALTER MYERS FELLOW, LIVERPOOL UNIVERSITY 
AND 
JOHN L. TODD, B.A., M.D. McGill 
THE great need of a good routine method of searching for the parasite in 
persons supposed to be infected with trypanosomes has long been apparent to 
us. 
When the investigation or human trypanosomiasis was commenced it was 
thought, from the analogy of similar diseases in animals, that the microscopical 
examination of body fluids, particularly blood, and their experimental inoculation 
into laboratory animals would be the two methods which might be employed in the 
examination of suspected individuals.' Animal inoculations were soon found to be 
impracticable because of the uncertain and variable pathogenicity of T. gambiense to 
all ordinary laboratory animals, 1 ' 2 and the examination of the blood alone was relied 
upon for diagnosis. Unfortunately, the parasites appeared only periodically in the 
peripheral circulation of even known cases, and often a prolonged search of many 
preparations was without result or only revealed a single parasite. Therefore 
repeated and tedious examinations of many preparations were necessary before a 
suspected case could, even tentatively, be said to be uninfected. 
It was found that if infected blood were mixed with some diluent which 
prevented coagulation and centrifugalized, the parasites were deposited, along with the 
white corpuscles, between the red cells and serum. 3 Various methods of centrifugalizing 
large (5 c.cm.) or small (-5 c. cm.) quantities of blood were devised. During the past two 
years We have employed a simple method of centrifugalizing small quantities of blood 
which has given very satisfactory results. An inspection of the accompanying charts 
(Figs. 1 and 2) will suggest how frequently blood negative to coverslip examination has 
been positive when examined by this method. 
* Dr. Todd informs rue that this paper was written at Nouvelle Anvers, in August, 1904. A copy arrived in Liverpool 
two months later, but was unfortunately mislaid, so that the publication of the article has been unfortunately delayed until now. 
(Signed) Ronald Ross, Professor of Tropical Medicine, University of Liverpool. 
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