Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 1.djvu/157

Rh pains and numbness in his legs, and also appeared to be in a hopeless condition. He left hospital on March 26th. I confess I expected to learn of his death within a few weeks.

From time to time I heard from him. At first the reports were not encouraging, but, as the summer advanced, they told of gradual improvement, of fever and sweats diminishing, of these being sometimes altogether absent, and, finally they spoke of decided improvement. From the beginning of July, 1907, there was no fever, although for a month or two longer the daily range of the thermometer was still abnormally large (96 deg. to 99 deg.).

After October the temperature became normal or subnormal. The nocturnal sweats had ceased in August. Weight steadily increased to 11 stone, the spleen and liver diminished in size, and he began to get about.

Wishing to satisfy myself that the good accounts I had received were well-founded, I visited the patient at his home in Norfolk on January 19th, I was gratified to find that there had been no exaggeration. The patient, who had left hospital the previous March, apparently in a dying condition, was indeed practically well. He could walk at a stretch about one mile, his weight was 11 stone 1 lb. (now 11 stone 3 lb.), his liver was of normal dimensions, and his spleen, which, when he left hospital, had extended well to the right of the umbilicus, though still enlarged was very much reduced, the anterior border being at least 3 in. to the left of the umbilicus. He complained a little of various paraesthesiae, especially in his calves, sensations of wet, cold and stiffness; his knee jerks were somewhat exaggerated, and there was a suspicion of left ankle clonus. In other respects, though not vigorous, he was well, and he was craving to be at work again.

Several points of special interest have induced me to bring this case before the Society. There can be no