THE NATURE OF HUMAN TICK-FEVER 
Physical examination: Temperature ror-4, revealed nothing abnormal, spleen not 
palpable. Spirochaetes, not numerous, were seen in fresh and stained specimens of the 
blood by Dr. Heibcrg-. In spite of repeated examinations, spirilla were never again seen 
in the blood of this patient, although on January u and 15 there was a well-marked rise 
of temperature (highest 102), and again between January 20 and }i there was constantly 
a slight (gg to 100) evening temperature to be recorded. 
CASE 8 {Chart No. 2). — Male, age 19, first seen March 5, still under observation. 
History : — Patient is a soldier, one of a detachment on their way from the Lower 
Congo to Lake Kivu. He slept on the night between the 23rd and 24th of February 
at Nyangwc. He fell sick on March 2, at Kasongo, with frontal headache, pain in 
the back and limbs, anorexia, vomiting, continued constipation, and fever. The liver 
was normal ; the spleen slightly enlarged and tender. The course of the disease was 
uneventful. The results of blood examinations are entered on the chart. 
CASE 9 {Clmrt No. 3). — Male, age 20; first seen March 5, still under observation. 
History : — Patient belongs to the S5me attachment of soldiers as Case 8. The history 
and symptoms were the same in both, save that the illness commenced in this case on 
March 3, and there was no vomiting. 
The temperature curves of these two cases are remarkably similar. 
CASE 10 (Chart No. 4). — Female, age 5; first seen on March 21, 1005, still under 
observation. 
Tiie patient is the daughter of a soldier on his way from the north of the Lake 
Tanganyika to the Lower Congo. She was bitten near Kabambarre on the night between 
the 13th and 14th of March. The illness commenced on March 20 with headache, pain 
in all the body, restlessness, anorexia, no vomitins^, constipation, and fever. Liver was 
not enlarged. At the first examination the spleen was found to extend to 8cm. below 
the costal margin. On March 25 and 26 the pulse was irregular. No malarial parasites 
have ever been seen in this case. 
CASE 11 {Chart No. 5). — Female, age 28; first seen on March 21, 1005; still undei 
observation. 
Patient is the mother of the preceding case, and was bitten at the same time. Her 
illness commenced on March 21 with the usual symptoms, the headache being distinctly 
temporal. There was no vomiting, and the spleen was never enlarged. 
CASE 12. — Female, age 27; seen first on March 21; still under observation 
Patient is the wife of a soldier on his way from the Lower Congo to Lake 
Tanganyika. There is no history of tick bite. Illness commenced March iq with general 
malaise, pain in forehead and nape of neck, anorexia ■ — but no vomiting, cons^pp^ron. 
Liver normal. Spleen enlarged and tender. Blood was examined on March 21, and 
soirilla found. The temperature on March 21 was 100.4; it has since been normal, and 
parasites have not been again seen. 
Reports o f European Cases. 
J. E. D. (Chart No. 6). (Patient's Own Notes.) 
Nov. 25. — This evening felt tired and unable to work as usual ; have been partially 
constipated for past four days 
Nov. 26. — This morning was unable to take breakfast — loathing for food — neverthe- 
less, swallowed a little bread and tea, and started at eight o'clock, after the sun had well 
risen, on a seven mile walk to Vieux Kasongo. During the first hour felt fairly " fit," 
and refused to ride on mule. As the sun became warmer, commenced to feel uncom- 
fortable, arms ached so that it was almost impossible to hold sun-umbrella, and reached 
