— 440 — . 
riiis suggestion is supportée! by the faut that 13 of the 212 ca¬ 
ses in whom trypanosomes were not found, although auto-agglu¬ 
tination of the red cells was présent, ultimately died of « Slee- 
ping Sickness », while ten of the persons in whom neither trypa¬ 
nosomes nor auto-agglutination of the red cells were seen died 
within three vears of the same disease ; it was possible to keep 
track of onlv a verv small percentage of the total number ot 
persons examined and it is possible that very many more than 
these mav hâve died of trvpanosomiasis. 
But even if a correction be made for this source of error, the 
différence between the number of persons found to be infected 
with trypanosomes and of those v'ho were not infected makes it 
very évident that tr\'panosomes may occur without accompanying 
auto-agglutination and that while many ctises, in whom auto^g- 
glutination is présent, may be subject to trypanosomiasis, still, 
auto-agglutination mav occur without that disease. 
In order to détermine the constanev with which auto-aggluti¬ 
nation is présent in cases of Sleeping Isickness, a sériés of 26 ca¬ 
ses of tr\'panosomiasis was observed for periods varving from 
three weeks to four months. Coverslip préparations of the blood 
were made and examined, practicallv, dailv ; from these obser¬ 
vations it is possible to State that auto-agglutination may be pré¬ 
sent in patients of either sex, of anv âge and at ail stages of the 
disease. 
Among those persons in Table I who were examined but once, auto-ag¬ 
glutination was présent in 91 0/0 of the apparently healthy individuals in 
whom trypanosomes were found. It was présent in 82,5 0/0 of the infected 
natives who had enlarged cervial glands and it was présent in 88 ojo of 
the cases who were definite cases of clinical Sleeping Sickness. 
From the records of these 26 cases, it does not appear that 
auto-agglutination is especial]\" apt to be constantly présent at 
any particular stage of the disease. Auto-agglutination may be 
présent whether the température be high or low, whether the 
puise be slow or fast, and whether the trypanosomes be présent 
in, or absent from, the peripheral circulation. It existed in three 
cases of trypanosomiasis in Ifuropeans ; ('onsequentlv, it is pro¬ 
bable that its presence does not dépend upon infection bv mala¬ 
ria, filaria, worms, or other parasites, which mav be assumed 
to be présent in almost ail native Africans. 
Although there does not seen to be anv immédiate connection 
