403 
Quinine and Methylene Blue Treatment 
Quinine 30 grains daily, combined with methylene blue, 12 
grains daily, was administered by the mouth from February 21 till 
March 9, and again at other intervals as noted on the chart. No 
marked trypanocidal effect can be noticed. 
During treatment with these drugs, however, as also with atoxyl, 
the patient’s face, which had before been puffy and oedematous, 
especially about the eyelids, became more firm and clear cut. ihe 
eyelids became again oedematous soon after these drugs were 
withheld. It would seem, therefore, that quinine and methylene 
blue, as well as atoxyl, had some beneficial effect clinically. The 
following drugs were also given without apparent results: — 
( a ) Trypsin and Atnylopsin Injections. —20 min. ol each daily. 
(b) Succinamide of Mercury Injection. —One-fifth grain almost 
daily. 
( c ) Izal Oil. —8 min. daily, by mouth. 
( d ) Trypan Red. — By the mouth in doses of O' 5 grain, 1 grain, 
and 1 grain respectively on three successive days. No albuminuria 
resulted, but the drug was stopped on account of the development 
of severe vomiting. 
(e) Potassium Iodide. — 30 grains daily, by mouth. 
We beg to apologise for complicating the case with so many 
treatments, but owing to the unsuitability of atoxyl in the patient 
other treatment was a clinical necessity. 
VIII. EFFECT OF TRYPANOSOME ‘VACCINES 
On April 19 we commenced to give our patient subcutaneous 
injections of so-called vaccine. This vaccine was obtained from the 
blood of a rat inoculated from our patient. Ihe rat was killed 
when the parasites were extremely numerous (500,000 pei cubic 
millimetre of blood). The blood was then drawn from its heart 
aseptically, and mixed with an equal volume of normal saline. 
The red cells were allowed to settle, and the supernatant fluid 
pipetted off. This latter contained most of the trypanosomes and 
the number per cubic millimetre was estimated by the thick film 
method. It was then sterilised by heating to 55° C. for half-an-hour, 
and by adding trikresol so that it contained o 2 pei cent. 
