295 
Dutton’s  and  Todd’s  tig'ures  are,  for  early  cases  :  — 
Glnncl  puncture  ...  ...  ...  ...  ...  ...  cjS'5  ^ucces^cs 
lilnntl  (partly  orilinary  preparations,  partly  centri{ugod)...  .n'4“o 
Ccrrliro-spinal  fluid .  n 
The  results  obtained  by  Greig  and  Gray*  approach  very  closely 
those  just  given,  but  as  cases  in  all  stages  of  the  disease  are  included, 
ihey  are  not  very  valuable  for  our  purpose  :  — 
Gland  puncture  ...  97*0^^ 
Blood  ...  ...  52 
Ccrebrn-spinal  fluid  84*9% 
Koch’st  earlier  results  gave  a  percentage  of  97-4  successful 
punctures,  and  he  states  ‘  dass  dieses  Symptom  (glandular  enlarge¬ 
ment)  bei  den  Trypanosomiasis-Kranken  ein  ganz  constantes  ist,  das 
nicht  wie  das  Auftreten  der  Trypanosomen  im  peripheren  Blutstrom 
starken  Schankungen  unterworfen  ist.’  When  he  found  that  the 
trypanosomes  were  banished  from  the  glands  by  the  use  of  Atoxyl 
he  was  compelled  to  revert  to  the  examination  of  the  blood  in  order 
to  control  the  treatment,  and  then  found  that  by  his  improved  method, 
he  was  able  to  detect  the  parasites  in  40  per  cent,  of  the  cases  by  a 
single  examination,  and  in  practically  all  of  them  after  the  fifth.  He 
goes  on  to  say  that  where  the  examination  of  large  bodies  of  natives 
is  in  question  his  method  would  occupy  too  much  time,  except  in  the 
case  where  the  treatment  is  being  controlled,  and  adds  that  for  quick- 
diagnosis  gland  puncture  must  remain  the  most  practical  (zweek- 
miissigste). 
Martin  and  LeboeufJ  repeated  Dutton’s  and  Todd’s  work  in  the 
French  Congo,  and  their  results  differ  to  some  extent  for  cases 
‘  en  bon  etat’ :  — ■ 
Centrifuged  biood  ...  loo'oo  snccesscii  (6  crises) 
Gland  juice  (complete)  ...  90-56  %  „ 
Cerebro-spinnl  fluid  ...  28-57  ”0  » 
Their  technique  in  centrifuging  the  blood  was  most  thorough, 
involving  three  separate  centrifugations,  occupying  in  all  between 
Greig  and  Gra_v,  1905,  Roy.  Soc.  Sleeping  Sickness  Reports,  Xo.  VI. 
+  Koch,  igoy,  Deutsche  med.  tVochenschrift,  Jahrgang  33,  Xo.  2. 
I  Martin  and  Leboeuf,  igoS,  Bull.  .Soc.  path.  exot.  T.  I,  X'o.  2. 
