263 
The numbers of trypanosomes found were scrupulously 
recorded, and the smoothness and regularity of the graph suggest 
that there was no very great error of observation. The blood was 
taken every day at about 10 a.m., but on April 5 and 6 several 
counts were made daily. 
It will be seen that between February 16 and April 30 (seventy- 
three days) there were eleven rises in the number of the parasites. 
Up to April 7 there were seven rises, at intervals of seven or eight 
days. During this period the patient was given no atoxyl, but was 
treated with large doses of quinine (30 to 40 gr.) daily, with 
frequent doses of methylene blue and with trypan red on March 
17, 18, 19, and 20. 
On April 5 it was decided to administer atoxyl again, as shown 
on the chart, together with mercury and other treatment. 
The temperatures were taken by the sister of the ward, and it 
will be seen that there has always been a tendency to a slight rise 
in temperature concurrent with the rise in the number of parasites 
—the two curves thus confirming each other. Only the maximum 
and minimum temperatures are entered in the accompanying chart. 
The great regularity of the rises can scarcely be compatible with 
a mere chance distribution. It will also be observed that the rises 
were of two kinds—namely, high rises and low rises—and that the 
two kinds alternated with regular periodicity until April 18, at 
which point the cycle appears to have become distorted—probably 
in consequence of the treatment. The regularity of alternation of 
the high and low rises is so well marked as to recall the picture of 
a double tertian malaria, and to suggest that two independent sets 
of parasites may exist in the patient, just as often happens in 
malaria. 
The large dose of atoxyl given on April 5 seems to have had no 
effect whatever on the following rise; but the succeeding rises were 
apparently modified for some reason. I he value of the 
enumerative method for therapeutical research is obvious. 
Of course, many other facts in connection with the case have 
been recorded, and parallel work is being done on sub-inoculated 
animals and on the parasites. It is therefore inadvisable to attempt 
at present any discussion of the many interesting theoretical 
questions which arise. 
