194 
Relapsing Fever 
May 13th. Awoke blind, with the exception of being able to 
distinguish the windows. The eyes very painful and eyelids swollen. 
Vomited about 6.30 p.m. Severe rheumatoid pains in back and limbs. 
Cough troublesome. Spirochaetes were found in the blood. 
May 14th. The previous da 3 ^’s symptoms continued. 
May 15th. Cough almost gone ; head better. Blind and deaf. 
May 16th. Passed a good night. Still blind, but eyes less painful 
and cough almost gone. 
May 17th. Headache and eyes better; photophobia less. 
Maj" 18th. Pain in head and eyes increased towards the evening 
and rheumatoid pains severe. 
May 19th. Awoke with the same s^’mptoms as the previous evening 
but during the day they became better and the headache and pain in 
eyes went away. Still blind. 
May 20th. Woke up at 6 a.m. to find sight had returned. Eyes 
very sensitive to light and bad headache. During the day the eyes 
became less sensitive and vision cleared. 
May 21st. Passed a good night. Head and eyes almost well. 
Temperature normal. 
May 22nd. Vomited once and returned to bed. 
May 25th. Also vomited about 8 a.m. 
No further symptoms were noticed after this date. 
One of the interesting features of this case is the extraordinarily 
long incubation period of 19 days. Moreover, although iritis is a 
common complication of this disease, acute photophobia accompanied 
by blindness has not previously been recorded. 
From a comparison of the symptoms in natives and Europeans 
infected in Uganda and -German East Africa, P. H. Ross (1907) has 
distinguished two types of the disease. Dutton and Todd (1905), 
however, in the Congo found practically no difference between the 
efi’ects of the disease in Europeans and natives. The milder character 
of the disease in natives may be explained by the fact that infection 
has taken place in childhood (Koch, 1906), as most of the children are 
exposed to infection in the native huts where the ticks occur. 
Prognosis. The prognosis for both Europeans and natives is usually 
favourable, but death may occur, in which case its approach is indicated 
by a rapid fall of temperature without any improvement of the general 
symptoms. 
The mortality is not more than 5 per cent, under ordinary conditions, 
but in adverse circumstances it ma}’ be much higher. Thus, Dutton 
