seemed to cause nausea. Relatively the dose was a medium one, as 
she weighed only ninety pounds when treatment commenced. 
On November ist her right ankle became swollen and so painful 
she could not walk; but from the time atoxyl was commenced 
improvement set in and persisted. The erythema and the trypano¬ 
somes disappeared; temperature, which had been variable, became 
steady and normal, and her weight rapidly increased Within a 
couple of months, from being saUow and emaciated she became ruddy 
and plump, and felt in excellent health. 
After her discharge she returned from time to time to hospital to 
show herself and to have her blood examined. Trypanosomes were 
not found again; the erythema did not return; monkeys injected 
(January I2th, 1906) with her blood were not infected (March 29th, 
1906), and good health continued. She left for the Congo on 8th 
March, 1907, against advice, but promising to continue the atoxyl 
injections. 
I am informed that a letter, dated nth September. 190;, had 
been received from her husband in which it is stated that she has 
been getting stronger and has been able to do quite a lot of language 
work. But she has to take great care, for evidently there is 
something causing a rise of temperature occasionally.’ Soon after 
her arrival on the Congo she had a haemorrhage of some sort which 
pulled her down very much; apparently, she has taken some time to 
recover from this; possibly, judging by the temperature, the 
trypanosomes are again active. 
Vn.—H. C. C. S., aged 56, an engineer, arrived at Benguella, 
Portuguese West Africa, in June, 1904. His work took him up 
country some 100 to 150 miles from the coast. Pie had his first 
fever the following November. Attacks recurring very frequently, 
he had to be invalided, and arrived in England on May 29th, 1905. 
Soon after landing he had two attacks. I first saw him on June 23rd. 
He had no fever at the time, but he was anaemic and his spleen was 
enormously enlarged. I put him on quinine, 15 grains every tenth 
and eleventh day. Notwithstanding these doses fever kept recurring 
every few days. My locum tenem saw him on August 15th and 
ordered him five grains of quinine three times a day, apparently 
with benefit, for in a note dated August 24th it is stated that he had 
no fever, and that the spleen could no longer he felt. Subsequently 
