u8 THOMPSON YATES AND JOHNSTON LABORATORIES REPORT 
White Fathers' Mission at the sixth mile in almost a collapsed state. Was carried in 
hammock to destination. Blood was examined at 4 p.m., and nothing seen. Six grains 
of calomel taken, and two small motions obtained. During- the night was much distressed 
by fulness of the abdomen, and vomited four times. A few drops TV. Opii. gave much 
relief. 
Nov. 27.— Felt very slightly better in early morning. Head felt as if " muffled up," 
and severe throbbing, frontal aching soon developed. Had slight pains in small of back. 
Fulness and distention of abdomen as distressing as ever. Four cathartic pills taken in 
the morning had no effect, so calomel grs. 6 was taken, and several small liquid stools 
were passed during the night. Blood was examined at nine this morning and spiro- 
chaetes found. 
Nov. 28. — Passed a bad night (7J grains of antipyrine taken at 1 a.m.), because of 
severe throbbing headache and distressing fulness of abdomen ; vomited twice during 
the night. Tried to get up in early morning, but soon returned to bed because cf fever, 
weakness, and exhaustion ; headache not so bad. Blood examined, spirochaetes present. 
Antipyrine grs. 10 taken at noon and saline laxative in the afternoon. 
Nov. 29. — Was awake, up and down, all night, but not so distressed as during two 
preceding nights. Started in early morning, carried in hammock, for Kasongo, where 
arrived at 8 a.m. Throughout this access of fever a constant soapy taste was noted in 
the saliva. 
Nov. 30. — Much better, went for walk ; noted bodily weakness. 
Dec. 1. — Passed fair night. Woke up after after-dinner nap with distinct oedema 
around eyes. Herpes has formed on upper lip and just within right nostril ; there are 
two small ulcers on gums. 
Dec. 2 to 6. — Save for slight looseness of bowels absolutely well. 
Dec. 7. — Slight weariness in arms and legs ; on coming in from morning bicycle ride 
felt shivery. 
Dec. 8. — In bed, same symptoms as in previous attack — headache, boneache, lassi- 
tude, distaste for food — but no vomiting. Had no great thirst. 
Dec. 9. — Same condition, constipated. 
Dec. 10. — During early morning temperature fell to 97 — a slight perspiration preced- 
ing — headache disappeared and appetite returned. 
Dec. 11-15. — Fairly well and able to work. 
Dec. 16. — Fever recurs in usual manner. 
Dec. 17. — Headache bad; 75 grains of antipyrine at noon. Temperature fell to 
normal after tepid bath at 10 p.m. 
Dec. 18. — Weak, bowels loose, otherwise well. 
For the following week (Dec. 19-25) felt very well, appetite was good. From Dec. 
26 had a constant slight evening temperature, was rather bilious and constipated (calomel 
grs. 5, Dec. 31), and had a slight localised boneache, especially in the fere-arms. 
Jan. 7. — Felt chilly and good for nothing this evening. 
Jan. 8, 9, and 10. — Recurrence of fever with same symptoms as before. The tempera- 
ture suddenly fell on the night of the gth during a second heavy sweat. There was no 
further recurrence cf fever. After each attack there was slight looseness of bowels and 
increase in amount and frequency of urine. The slight ulcer in the nostril lasted for 
some time after the labial herpes had disappeared. The spleen was tender, but was 
never easily palpable. For a fortnight succeeding the last attack occasional small 
evening rises of temperature with slight malaise were recorded. The appetite and general 
sense of well-being quickly improved under arsenic. Good health continued until about 
February 15.*. 
The temperature chart and diary of this case record graphically the 
classical description of relapsing fever (8, 9). Spirilla were seen in the blood 
during each access of fever. Malarial parasites were always absent, and 
L tie patient has never at any time had malarial fever. 
' No spirochaetes were seen during J. L. D.'s tat^l illness. 
