1 12 THOMPSON YATES AND JOHNSTON LABORATORIES REPORT 
The History of Human Tick-fever in the Oriental Province of the Congo 
Free State. 
Livingstone mentions being annoyed by human ticks while at Nyangwe, 
in i 8; I , but he does not speak of them as producing disease (2, 3), although 
he was well acquainted with their pathogenic properties (4, 5). Dr. Hinde, 
who accompanied the expedition which drove the Arabs from this part of the 
Free State 111 1892-94, saw, at Kasongo, ticks and sick persons who 
attributed their illness to the bites of these acarids (6). Although he 
lost some of his own men from the same cause, he believed that the tick 
was harmless, and the natives had died through the force of an ignorant 
superstition. His opinion has been shared by practically all the European- 
knowing this district whom we have met. Each told us of the " Kimputu" — 
the local name for the tick — and of the imagined deadliness of its bite. 
Almost no one believed that there might be some truth in the natives' belief. 
As a result, all who reported ill through "Kimputu" bites w-re at once 
suspected of malingering. 
It is not altogether difficult to see how such a mistake could perpetuate 
itself. io a casual observer the human tick resembles the ordinary 
" harmless " cattle tick. 
As Dr. Hinde justly observed (6), ills which have no connection with the 
tick are attributed by the natives to its bites. The real nature of tick-fever 
has probably escaped recognition by physicians — microscopes have not been 
used — through this fact, and because, as seems probable, atypical cases- 
such as those described below, " No. 7 " and J. L. T." — may not infrequently 
occur. Among all the natives whom we have questioned, only one has 
certainly recognised the recurrent nature of tick-fever. 
In the more typical cases the symptoms of a disease which prostrates 
the patient on one day and leaves him free from fever on the next must have 
puzzled many, who could not suspect their specific nature, were it not that 
to most persons in this part of Africa every fever is malarial, and quinine is 
at once given. The naturally falling temperature of relapsing fever might 
thus be easily made to furnish the " therapeutic proof " of its malarial nature. 
Our own experience illustrates how easily mistakes might occur in diagnoses 
uncontrolled by the microscope, and based on only a single observation made, 
perhaps, between the attacks. Since we have been in the Oriental province 
twenty-four reputed cases of tick-fever have come, or have been sent, to us. 
The symptoms of seven of these patients were explainable on other grounds. 
Six were infected with trypanosomata, one with malarial parasites. Seven 
of the remaining cases gave histories similar to that recorded below in Case 
•5, and no cause for their illness was discoverable during the one or two days 
that they were und a r our notice. In only ten did we find spirochaetes. We 
have in addition seen spirochaetes in two soldiers, new-comers, who had never 
heard of the " Kimputu." In all we have had under observation twelve natives 
infected with spirochaetes. 
