Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 1.djvu/154



aged forty-four, a missionary, was admitted into the Seamen's Hospital Society's Branch Hospital, Royal Albert Dock, on November 1st, 1906, suffering from fever, night sweats, and enlargement of the liver and spleen.

The more important points of his previous medical history are as follows : He had had two spells of service in India, the first of seven and a half years (November, 1889, to March, 1897), the second, after eighteen months' furlough in England, of five and a half years (October, 1898, to April, 1904). While in India he was stationed at Calcutta and the Nuddea District, about eighty miles north of Calcutta. His duties took him about the surrounding country.

In May, 1890, he is said to have had enteric fever with a relapse. During his furlough in 1897-98 he suffered from neurasthenic symptoms—head tiredness, lapse of memory. Similar nervous symptoms supervened again towards the end of his second tour of service in India, induced, apparently, by severe domestic affliction.

The commencement of his present illness seems to date from about September, 1903, when he had the first of a long series of febrile attacks, which recurred, with considerable regularity, about once a fortnight. These continuing and his general condition gradually deteriorating, he was sent home, arriving in England in April, 1904. Dr. Harford, who saw him during the following July, informed me that at that time there was no enlargement