Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 1.djvu/158

130 question about the correctness of the diagnosis : the clinical symptoms, together with the microscopical findings, are conclusive for kala-azar. The points of interest I desire to call attention to are as follows:—

1. After a chronic febrile illness lasting over one year (September, 1903, to October, 1904) complete cessation of all febrile symptoms, followed by restoration of weight, and some, though not full, return of physical vigour.

2. After a spell of comparatively good health for at least fifteen months (November, 1904, to March, 1906), recurrence of all the symptoms and in aggravated form.

3. After this severe relapse, during which the patient nearly died, apparent complete recovery.

4. Although at the time the drug did not appear to be of much service, the possibility that the atoxyl brought about or conduced to the recovery.

I may mention in conclusion, although I do not think it could have had anything to do with the fortunate issue of the case, that while in hospital the patient was inoculated with scrapings from a Delhi boil (Oriental sore), in which the characteristic parasite had been found some weeks previously. Two students were inoculated from the same boil at the same time as the patient, but in neither patient nor students did the inoculations "take." This failure may be attributable to the fact that at the time the inoculations were made the boil may have been in the involution stage, for shortly afterwards, I am informed, it began to show indications of healing.

said he did not propose to criticise the very interesting paper to which they had listened further than to cite a case of successful treatment of the same disease. The symptoms the Presi-