1 1 6 THOMPSON YATES AND JOHNSTON LABORATORIES REPORT 
Thorax : Pericardium and pleura normal ; about soccm. clear fluid in pericardial 
sac. Heart, weight 114 grammes, on whoie fairly normal; muscle pale, firm, slight 
fatty change at apex of papillary muscle. The extended valves measure — pulmonary 
5cm., tricuspid 9.26cm., mitral 8cm., aoitic 4.75cm. 
Lungs together weighed 342 grammes, are very pale, otherwise normal. 
Liver: Weight 1,132 grammes, measures 23 by 14 by 8cm.; cuts firmly, on section 
very yellow and shiny ; no amyloid reaction. Gall bladder pale, moderately filled with 
viscid bile. 
Spleen: Weight 342 grammes, measures 15 by 8.75 by 5.5cm.; cuts firm and hard, 
not easily friable. 
Kidneys: Weight together 114 grammes, right measures 7.8 by 4.6 by 2.5cm., 
cortex 0.6cm., both are almos; bloodless and cut firmly, capsule peels with ease; colour, 
particularly in pyramids, is dirty, brownish-yellow, suggesting fatty degeneration. 
Bladder : Normal, filled with highly coloured urine. 
Pancreas normal. Stomach and intestines contained no food, many round worms, 
and very many anchylostomes. 
Lymphatic glands normal. Bone marrow at middle of femur was saffron-coloured 
and firm. 
Films taken at the autopsy showed the continued presence of spirochaetes. 
CASE 5. — Female, age 28; under partial observation during course of illness. 
History: — The patient, coming from Stanleyville, arrived at Nyangwe on November 
13. The illness commenced there on November 22 with fever, headache, and pain in 
the limbs. There was no history of a tick bite. On November 23, fever and pain 
persist ; severe vomiting. November 25, temperature 99.6, feels almost well, complains 
bitterly of aching thighs and calves. Patient remained well until December 4, when 
the symptoms recurred and spirilla were found in the blood (first examination). This, 
the second attack, lasted until December 8. There was then a complete absence of 
symptoms until December 17, when the third and last attack came on with severe 
vomiting, boneache, and fever. 
CASE 6. — Female, age 18; under partial observation during course of illness. 
History: — Patient, coming from Stanleyville, arrived at Nyangwe on November 13. 
The illness commenced there on November 21 with fever, very severe headache, vomit- 
ing (once), diarrhoea, and pain in the back. There is no history of a tick bite. On 
November 22 and 23 the temperature varied between 104.5 at night and 101 in the 
morning. On November 24 temperature normal, and patient, save weakness, well. 
Second attack commenced on November 29, with the same symptoms, evening tem- 
perature 104. On the afternoon of November 30 profuse perspiration CEme on, and the 
temperature fell to normal. Patient then remained without fever until December 14 and 
15, when the usual symptoms returned, evening temperature 103. December 16, tem- 
perature returned to normal, and patient remained well. 
Lather profuse expistaxis occurred in this case on November 22 and 29. The spleen, 
slightly enlarged after the first attack was, after the third, 5cm. below the costal 
margin. The blood was examined on November 29, and numerous spirochaetes seen. 
CASE 7. — Male, age 26; seen January 6, at Kasongo ; under observation for five 
weeks. 
History : — Patient has lived in Kasongo for the past two years. He states that about 
a week or ten days ago he was bitten during the night by two ticks. He caught them, 
burned them, cut his skin at the site of the bites, and rubbed in the ashes as a preventive 
against tick fever.* 
Two days ago his illness commenced, he complained of feeling cold, having fever, 
trembling and weakness. He has been unable to take food for two days. 
* This is the treatment usually employed by natives of this district for tick bites. Its prophylactic 
powers are widely believed in. Livingstone mentions (5) an analogous practice. 
