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C.O. 885

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began to show signs of fatigue on the march, and on arrival at Maifoni on the 18th September the dog was decidedly ill with the following symptoms: running from the eyes, staring coat, very dull and sleepy, photophobia, ophthalmia, both eyes, cornea of both eyes nebulous. On September 22nd the blood was examined and showed the presence of trypanosomes, and dog B was inoculated with 1 c.c. blood from dog A. On September 22nd treatment was begun by injections of 1 c.c. sub- cutaneously of the mixture of methylene blue and perchloride of mercury, as men- tioned on page 1. These injections were continued daily for 10 days up to the of 1st October, during which period the temperature ranged between 103° and 105° F., and blood examinations made on the 27th and 29th September showed presence trypanosomes.

On 1st October the injections ceased. On 3rd October the blood was examined and trypanosomes found present.

The dog rapidly grew worse and slept almost continuously; he had to be roused to take milk or water. From the 6th October his temperature showed marked morning and evening variations, and finally he died on the night of the 8th October.

Dog B. (See Charts Nos. 3 and 4.)

22nd September.-Inoculated with 1 c.c. of blood from dog A, his blood having been previously examined and found free from trypanosomes.

27th September.—The examination of the blood gave a negative result. 29th September.-The examination of the blood still gave a negative result. 1st October.-Dog's temperature, 105 4° F. Examination of the blood showed Treatment by subcutaneous injections of 1 c.o.

a great many trypanosomes.

begun.

8th October.-Examination of the blood showed the presence of trypanosomes. 10th October.-Tenth day of treatment.

11th October.-Examination of blood showed the presence of trypanosomes;

treatment continued.

15th October. Fifteenth and last day of treatment.

16th October. Examination of blood showed presence of trypanosomes.

21st October. Great oscillations in temperature begun.

27th October.-The dog died.

Horse A-Poor in condition (see Charts 6 and 7).

27th September.-Blood examined and found free from trypanosomes. Inoou- lated with 5 c.c. of blood from dog A.

12th October.--Blood examined and trypanosomes found.

13th October.---Temperature very high, 105 4° F., and a great many trypano- somes in the blood. Treatment now begun on 16th day after inoculation.

16th October.-Blood examined and trypanosomes found. Great oscillations in temperature.

22nd October.-Last day of treatment.

23rd October.-Horse died suddenly at 11 a.m., and blood films taken two hours after death showed the presence of trypanosomes.

Horse B.-An animal in good condition (see Charts Nos. 8, 9A, and 98). 29th October.-Blood examined, no trypanosomes found.

Animal inoculated with 5 c.c. blood from black Government ox No. 1 with natural infection.

5th November.-Temperature, 104 4° F. Trypanosomes very numerous in the blood.

6th November-Treatment of the horse begun.

8th November.--Blood examined and no trypanosomes found.

At this stage calf B was inoculated with 5 c.c. blood from this horse.

15th November.-Tenth day of treatment.

17th November-Blood examined and no trypanosomes found.

19th November.-10 c.c. of blood inoculated from this horse into dog E.

5th December-Blood examined and trypanosomes found to have re-appeared. Temperature, 102′4° F.

30th December.-Blood again examined and trypanosomes again found to have disappeared from the peripheral circulation.

Remarks. Although trypanosomes were found to be absent from the blood on the 17th November, the temperature from the chart will be seen running an abnormal course, and hence the animal was kept still under careful observation; the temperature was taken regularly, and when on the 5th December it was found to be 102-4° F., the blood was examined and a positive result obtained. On the

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8th December the temperature again shot up to 103° F., and after this it continued to run an abnormal course until the 29th December, although the morning fall of temperature was very great. On the 30th December, when the temperature again rose slightly above the normal maximum, the blood was again examined but with a negative result.

It will be interesting to note that dog E (as will be seen from the case following this) which was inoculated with 10 c.c. of blood from this horse on the fourth day after the treatment ceased and when the blood did not show any trypanosomes on examination two days previous to the inoculation, has not developed the disease, for although the temperature of the dog has on several occasios exceeded its normal maximum of 1024° F., yet four careful examinations of the blood on such occasions gave a negative result, and so did the last examination of the blood made on the 30th December. It is now one month and 12 days since the dog was inoculated.

From the foregoing it may be stated that the treatment in this case had the effect of removing the trypanosomes from the peripheral circulation whereby phase A of the organism (according to Sir Rubert Boyce-see page 4 on the life- history of the trypanosome) passed into phase B of its life-cycle, and that during this period a quantity as much as 10 c.c. of blood could be inoculated into a dog without reproducing the disease, which apart from microscopical examination is very confirmatory proof of absence of the organism from the peripheral circulation. If, again, according to Sir Rubert Boyce (page 5), it may be accepted that mercury alone has not the slightest effect on the ordinary phase of the trypanosome, viz., phase A, then it may be concluded that the result of the treatment was really achieved by the methylene blue, which removed the trypanosome from the blood, In this horse, therefore, since a relapse of and phase B of the life-cycle resulted. phase A has occurred and is likely to recur again, another course of injections of perchloride of mercury is indicated, as this agent has been found to be especially effective in phase B of the organism.

This horse will continue under observation and will be subjected to further treatment by injections of perchloride of mercury so as to try and destroy com- pletely phase B of the organism and thus prevent the recurrence of phase A, and so eradicate the disease from the system, if possible. From this case of horse B it is clear that the effect of intravenous injections of methylene blue and per- chloride of mercury may remove the trypanosome from the peripheral circulation, during which period a quantity as much as 10 c.c. of blood may be inoculated into a dog without reproducing the disease, but it cannot be concluded that a complete cure has been established. Although the above result may be obtained by the treatment, it is necessary that the horse should be kept under observation subsequently for a considerable period, during which a temperature chart should be kept, and periodic examinations of the blood made when the temperature rises above the normal maximum, since recurrences of the organism in the circulation are possible.

Horse B has fallen off in condition to what he was before being experimented on during the last few days, his afternoon temperature has a rise of three or four points above the normal maximum. As to what the fate of the animal would be in the course of time if left alone without any further injections of perchloride of mercury, which I intend to carry out, is an uncertainty.

A further series of experiments on some horses infected with the disease by means of methylene blue alone and perchloride of mercury alone, and then on others by methylene blue followed by perchloride of mercury, would be desirable, so as to ascertain the specific action of each of these agents on the separate phases of the organism.

Dog E-(See Charts 10, 11a, and 118.)

18th November.-Blood examined, no trypanosomes found.

19th November.-Inoculated with 10 c.c. of blood from horse B; of this 5 0.c. subcutaneously into the flank and 5 c.c. subcutaneously in the neck.

24th November.-Temperature rose to 103 4° F.; the blood, on examination, gave a negative result.

28th November.-Temperature, 102° F. Abscess formed in the neck at seat of injection.

29th November.-Temperature, 102:6° F., abscess in the neck lanced. 10th December.-Temperature, 10389 F., but blood examination gave a nega- tive result.