• 4 ‘» 
the patient married and returned to Bcnguella during the auttmin 
of 1905. 
For a time he kept fairly well and did much hard work in the 
interior on railway construction. flc renieinbcrs that about this 
time he was bitten or stung on the leg by sonic unrccogniswl aninuL 
supposed to be a centipede or scorpion. The part swelled and was 
very painful. 
Fever now returned and, in addition, he got tlysentcr)-. Between 
the two he became so ill that he had once more to return to England, 
where he arrived on February 17th, 1906. 
I saw him the same day. He was in l>od. He had no fc\cr at 
the time, but he was intensely anaemic, emaciated and weak, and 
evidently very ill. Both spleen and liver were much enlarged, the 
latter being tender as well. He was passing from four to five 
dysenteric stools daily. Quinine he said, aggravated the d>-scntei)' 
and gave him severe gastralgia. I examined his finger blood but 
found no malaria or other parasites in it. As he had not taken 
quinine recently, I was surprised at the absence of malaria parasites 
saw him daily, and on 22nd February, ob.serving that the spleen 
ad undergone a sudden increase in size, and from this suspecting 
an impending malarial attack, I gave orders that I should be sent 
or so soon as temperature rose. A few hours later I was summoned 
e temperature was then 103°. I took blood films and found in 
em, not malaria para.sites. as I expected, but considerable numtieis 
aL Trw I of the skm 
erythera a characteristic patches of 
persisted. Trvnannc some fever of a remittent t>'pe 
gradually becoming [Z7r 
once instituted. ^ atoxyl treatment which was at 
genlTcorition or^e^pattn'r*' 
-proved, there were short™^ -adily 
assocated either with the appearance of T being 
tertian malaria parasites in the hlo ei ^ ^Wanosomes. or of benign 
It was impossible to say whether ^ without the microscope 
ay Whether a g.ven relapse was trypanosomal 
