88 
Effects foUoiving Tick-hites 
torticollis. In every case the rigidit}' was more marked and lasted 
longer in the neck than it did in the limbs. The pain and rigidity 
in the neck became more marked towards evening, this corresponding 
to an evening rise of temperature; the symptoms subsided during the 
night and wei'e slight during the day-time. The pain was increased 
when the patient exerted himself, or laid down. The evening rise of 
temperature, which never exceeded 101‘5°F. (38'5° C.) was preceded b}" 
chills and possessed an intermittent character. 
The acute neck-symptoms began to subside after the 8th-10th day, 
and recovery took place spontaneously; but the glandular enlargement 
persisted a month or more after recovery. The glands, however, 
became hard and painless. The retro-auricular and mastoid glands 
were enlarged in all cases; the glands of one side became enlarged 
before those of the other side, aud they appeared to stand in relation 
to small pimples on the scalp. The sub-maxillary glands were also 
enlarged, without there being, any signs of pharyngitis or tonsillitis. 
None of the enlarged glands suppurated. 
A slight papular eruption appeared on the 4th or oth day after the 
tick-bites had been inflicted. The papules were not larger than a pea, 
and they were followed by furfuraceous scaling, without any tendency 
to vesiculation. None of the papules suppurated. Only in the case of 
a two-year-old child was a characteristic generalised eruption observed.. 
In some cases, general weakness and muscular asthenia persisted for 
a time. 
Treatment. Aspirine and alkalies were given internally, besides 
purgatives; an ointment of potassium iodide and iodine was applied 
externally. The drugs exerted little effect upon the course of the 
disease. 
The ticks were nearly all Amblyomma hebraeum larvae, but Rhipi- 
cephalus simus larvae were also encountered ; they were determined by 
Mr C. W. Howard (Government Entomologist, Louren^o Marques). 
The symptoms here described have been confused locally with those 
of Spirochaetosis. The disease appears to have a cyclical character. 
Blood-smears obtained from the patients presented no pathological 
appearances. The affection requires further study; it is infrequent 
and occasionally benign, so that cases are not often observed in 
hospitals. 
