43 
9 grains; latterly it has been 3 grains every second day. At no time 
has there been any local reaction or sign of arsenical poisoning. 
Perchloride of mercury . — Notwithstanding several febrile attacks 
and frequent and careful examination of the blood, no trypanosomes 
appeared in the peripheral blood till May 21st. On that day a few 
were found. Atoxyl in 8-grain doses was being administered at the 
time. The same dose was repeated on the 22nd, 34th, 26th and 
28th. The trypanosomes having disappeared, hypodermics of 
perchloride of mercury in \ per cent, solution were commenced and 
repeated daily for fourteen days, the dose being rapidly increased 
from 15 to 30 minims (about one-seventh of a grain), at which it was 
kept for five days, when atoxyl was resumed in 2t-grain doses every 
second day. A week later there was another febrile attack 
concurrent with a fresh invasion of trypanosomes. The dose of 
atoxyl was now increased to five grains. After four injections of 
this strength, and the trypanosomes having disappeared, the 
perchloride was resumed from June 27th to July 6th. On July loth 
there was a rise of temperature to ior6°. but trypanosomes were not 
found, though carefully searched for; the atoxyl was again resumed. 
The perchloride injections having caused much pain and irritation, 
Hydrarg. c. creta, one grain three times a day, was substituted and 
continued from the 15th to the 22nd of July, when, the gums being 
slightly tender, it was stopped and the atoxyl resumed. On August 
nth temperature rose to ioiy°, and trypanosomes once more 
appeared in the blood. 
Parafuchsin . — Treatment with parafuchsin (kindly suggested and 
supplied by Professor Ehrlich) was begun on August i6th, atoxyl in 
2-f. si and occasionally in 8-grain doses every second day being 
continued at the same time. Beginning with 5 grains, the dose of 
parafuchsin was gradually raised by 5 grains at a time till 20 grains 
were taken three times a day by the mouth in cachet. These large 
doses, though continued till October 13th (nearly two months), caused 
no disturbance. There was no intestinal irritation, nor, although the 
urine and sweat were coloured by the drug, was there albuminuria or 
urinary irritation. Trypanosomes, which were present when the 
parafuchsin was commenced, persisted till August 29th — a fortnight. 
After this, though looked for almost daily, they disappeared for a 
time. 
