- 441 
hetween the presence of trypanosomes in the finger blood and 
the existence of auto-agglutination, still our records seen to show 
that a high grade of auto-agglutination is more likely to be ob- 
served soon after large numbers of trypanosomes bave been in 
the blood. For example, although auto-agglutination was very 
constantlv présent in these cases, it was more than once noticed 
that it was particularly marked when large numbers of trypano¬ 
somes had been présent, and on the five or six occasions when 
auto-agglutination was absent, it was immediatelv after the ab¬ 
sence of trypanosomes from the blood during a period of several 
da\'S. It is especiallv interesting that auto-agglutination disap- 
peared, with the trypanosomes, from the blood of one of our lùi- 
ropeans cases of trypanosonriasis in whom recovery seems to 
bave occurred (2). 
h"or our guidance, cases in which auto-agglutination was ex- 
tremely A\ell marked were recorded as « 4- 4- » ; the mere pré¬ 
sence of auto-agglutination was recorded as « 4 - »• In onlv three 
natives were trypanosomes not found where the (( -f 4- » grade of 
auto-agglutination was présent : one of these was a case of 
Relapsing Fever; another was a much emaciated, marasmatic 
individual and the third was a case of syphilis. The blood of a 
case of Beri-beri ( ?), who was constantlv examined during a 
period of three months, was ah\xo’s noted to be (( 4- » ; tiy'pano- 
somes were never found to be présent. These cases, together with 
one seen b\' Dudgeon (5), who observed a similar change in the 
blood of a West Indian negro affected with diseases other than 
trvpanosomiasis. Although autolvsis was présent in one case of 
Fh-emia, auto-agglutination did not occur in any one of 184 hos¬ 
pital patients who were observed b\' Moss (6). 
It is not possible to détermine from our records whether this • 
phenornenon is constantlv associated with anv qualitative or 
quantitative change in the blood. Xo suggestion is offered con- 
cerning the nature of the changes in the blood which lead to the 
manifestation of auto-agglutination. 
It is once again ccmcluded that auto-agglutination of the red 
cells frecjLiently occurs in human trypanosomiasis ; but that it 
nray be présent in other diseases and that trvpanosomiasis mav 
exist withoLit its appearance. 
