ii + THOMPSON YATES AND JOHNSTON LABORATORIES REPOR T 
The spleen is sometimes, not always, enlarged. Herpes, epistaxis, and 
hiccough, were complications observed. The most characteristic features 
of the disease have been the prostration of the patients during the attack of 
fever, and the quick return to comparative health with the fall of the 
temperature. 
The following case reports, charts, and -post-mortem finding certainly 
demonstrate the clinical identity of the tick-fever observed by us with the 
relapsing fever of the text-books (8, 9). 
Reports of Native Cases. 
CASE 1. — Female, age 27, seen at Lokandu, October 30, (904, under observation for 
two days. 
History : — Patient and her husband, a soldier, were on their w ay from Lake Tan- 
ganyika to the Lower Congo. On the night of October 12 she was bitten by ticks on 
the thigh, neck, and arm. Three ticks were caught in the morning, no obvious marks 
of the bites were left. The following day Kasongo was reached ; here the patient 
remained for a week. On October 21, the day after leaving Kasongo, she fell sick. 
The incubation period that is, the interval between the bites of the ticks and the 
appearance of symptoms, is, therefore, in this case about eight or nine days. On getting 
up in the morning she complained of terrible headache, accompanied by throbbing of 
the ears. Her husband says that there was fever but no shivering. The headache, 
though apparently chiefly frontal, extended around the head to the occiput. There 
was no accompanying nausea or vomiting. 
Present Condition: — Temperature sub-normal; pulse 70; respiration 20. The 
patient is a fairly developed woman ; no wasting. She has a pained expression, and 
keeps the head fixed. Because of severe headache has a piece of " tie-tie " — native 
cord — tied tightly around the head across the forehead. It is apparently disagreeable 
for her to be placed in a bright light. She has lost her appetite, and complains of a 
bad taste in the mouth. She walks gingerly with the help of a friend ; extremities are 
cold ; respirations somewhat laboured. Liver is not enlarged or tender. Spleen is 
distinctly enlarged, extends 5.5cm. -below costal margin, not tender. Tongue is flabby 
and furred. Patient otherwise normal. 
October 31st. — Temperature a.m., Q7.8 ; p.m., 101.2 ; respiration and pulse as before. 
Headache is still very severe. A slight fulness around eyes is noticed. 
Blood examination : — No malarial parasites or trypanosomes were seen in either 
fresh or stained preparations. In two stained films taken on October 30th two spiro- 
chaetes were seen. 
CASE 2. — Female, age 26, seen at Ukungwa, October 31, 1904; under observation 
for one day. 
History : — Patient was bitten a month ago by a tick. A week later high fever with 
chills commenced. At present has no fever, but is weak, quite thin, and still complains 
of severe headache and of pain in the eyes. Phvsical examination revealed nothing 
abnormal ; the spleen was not enlarged. No malarial parasites or trypanosomes were 
seen in either fresh or stained preparations of blood. In four stained films as many 
spirochaetes were seen. Many ticks were found in the house — a rest-house for native 
travellers — in which this patient lived. She w r as the w 7 ife of the caretaker, and was not 
a native of the district. 
CASE 3. — Male, age 20, seen November 6, 1904, at Sendwe ; under observation for 
two days. 
History : — Patient, a native of this neighbourhood had been employed as a labourer 
at Stanleyville. He was on his way home, and while at Ukungwa, where he slept in the 
house inhabited by Case 2, he was bitten by a tick. Patient says that symptoms 
