Hz 
GLAND PALPATION AND PUNCTURE 
Since Greig and Gray^ noted that trypanosomes were fairly 
constantly present in the enlarged glands of i>crsons suffering from 
trypanosomiasis, the efficiency of this means of diagnosing the disease 
in its earlier stages has been repeatedly demonstrated. Dutton and 
Todd^ were the first to recognise its practical imp<irtance, and thw 
experience led them to make the statement that ' every negro with 
enlarged glands must be considered, until the contrary is proved, to 
be a case of human trypanosomiasis.' Koch* confirmed the value of 
the method in the course of his work, and more recently the British 
investigators in Uganda have done the same. 
As compared with other means of detecting the disease, in the 
absence of definite symptoms, gland puncture is infinitely the best 
This has been shown so clearly and so often that no stress need be 
here. While enlargement of the glands does not occur with 
un ailing regularity in every case, the number of these is so 
comparatively small that it does not invalidate the practical utility of 
the method nor the prophylactic measures based on its application. 
n o tainmg our results, we have used the classification adopted by 
the ° schedule is arbitrary, and is one into which 
delrm 'T "r u"" the exad 
placed. elands should be 
practical rv perhaps of more academic than 
in the postecor tr.angle^rf thr„e’’cr'* 
examined, aL”of’these“^ 878 “had'’"'l 'Tf’ “"t 
20-85, classified as follows ^ P^'Pable glands, a percentage of 
Expressed 
+ 
+ - 
4 — 
5 
n i. 
36 
_ 
*837 
we have ^ rcentages of the total number of enlarged glands. 
