47 
almost disappeared when I saw him. The spleen was slightly 
enlarged, and he looked more anaemic than the blood count 
(4,000,000) indicated. Appetite was poor, and he felt weak and 
depressed. There was no palpitation or breathlessness, and no 
headache even when he had fever. The only pain he remembered 
was intense aching in the legs coming on every night and keeping 
him from sleeping; this disappeared when he left Leopoldville and 
has not recurred. 
On November the 8th, trypanosomes being present in small 
numbers in his blood and temperature being normal, for the first 
time during his illness the characteristic erythema showed itself on 
the skin of the trunk. At the same time and for a day or two 
previously he had been profoundly melancholic, so much so that I 
feared the nervous system was becoming implicated and that the 
terminal phase of the infection was about to set in. He was so 
depressed I was afraid to allow him to go out alone. 
On the day the erythema appeared (8th November) 1 gave him a 
hypodermic injection of half a grain of sodio-tartrate of antimony, 
and also on the following days i, i^, 2, and 2 grains respectively, and 
again after two days another 2 grains. The apparent effect of these 
injections was remarkable. By the third day the erythema had 
disappeared, his spirits had become good, and for the first time 
trypanosomes could not be found in the blood This hopeful 
condition persisted till November 26th, when depression, though not 
so intense as on the former occasion, returned and trypanosomes in 
greater number than I recollect to have seen them in human blood 
were once more found. On November 26th and 27th he had two 
grains of antimony by the mouth. I was afraid to resume the 
antimony hypodermics on account of the intense irritation and pain 
they gave rise to. Given by the mouth the drug caused nausea and 
seemed to increase the depression. It was stopped, therefore, and 
atoxyl resumed. By the 30th trypanosomes had again disappeared 
and the patient was feeling much better. He left for New York on 
December 12th, with instructions to continue the atoxyl. A letter 
just received states that he is feeling much better. 
The more important facts (especially as bearing’on treatment) of 
these ten cases are summarised in the following table: — 
