7 a. m. : Temperature, 39.3°; sweating. After a long search, one endoglobular parasite, about one fifth the size of a blood corpuscle, was found.

10 a. m.: The scanty urine appears like pure, venous blood; temperature, 38°.

11 a. m. : Chill; temperature, 39.3°.

12 m. : A very profuse sweat.

2 p. m. : 550 c.c. urine, with characteristics unchanged. 4 p.m.: Temperature, 39.8°; the sweating continues.

9 p. m. : Temperature, 39.5° to 38.6°; pulse, 132; 755 c.c. urine. The anemic hue of the skin has given way to an icteric discolorization. Burning on micturition has ceased.

October 10: 6 a.m.: Fever throughout the whole night, but no chill. Extreme anemia; severe icterus; 1100 c.c. dirty, brown red urine.

12 m.: Temperature, 39.3°; pulse, 132; 620 c.c. urine; sp. gr., 1012; containing one half, by volume, of a dark brown precipitate. Hemoglobin, 21 per cent.

3 p. m. : Temperature, 37.5°.

6 p. m. : Temperature, 37.4°. Restless, considerable vomiting; pulse,


9 p. m. : Temperature normal; intense exhaustion. Pulse, 128; urine, 1420 c.c.; clear ruby red.

October 11: Vomiting has ceased. Milk and egg in clyster. Highest temperature, 37.9°. During the day, over 3000 c.c. straw yellow urine; sp. gr., 1013. Hemoglobin, 14 per cent.

October 12: 6 a. m. : Temperature, 38°; pulse, 132. Large amount of urine; sp. gr., 1012; still containing a trace of albumin.

3 p. m. : Temperature, 39.6°. No endoglobular parasites. Marked leukocytosis.

6 p. m. : Unchanged.

October 13: Morning temperature, 38.6°.

3 p. m. : Temperature, 39.3°; the pulse fell temporarily to 116, but fluctuated generally between 128 and 140. Hallucinations. No parasites could be found in the blood, and no pigment in the leukocytes. Large amount of straw yellow urine, sp. gr., 1013, that showed, on boiling with acetic acid, only a trace of albumin. Hemoglobin, 14 per cent. Evening, condition better; during the night, fever.

October 14: Morning temperature temporarily 37.6° and 37.4°; evening, 39°; pulse, 138. Sweat promoted by a large, golden yellow stool. Spleen extends beyond the border of the ribs two finger breadths. Liver not enlarged. Icterus gradually disappearing. General condition always best when temperature highest. Alcohol; lots of milk, which is no longer vomited.

October 15: Temperature, morning, 39.8°; pulse, 140. In spite of this the strength has decidedly increased. Hemoglobin, 18.5 per cent.

12.30 p. m. : Profuse sweat. Temperature, 39°. Red blood corpuscles vary in size from one third to three times the normal. Even unstained, the megalocytes show large round nuclei. Typical endoglobular parasites could not be found. Whether isolated pigment granules were seen in a few leukocytes is uncertain. The spleen is somewhat smaller.

October 16: 8 a. m.: Temperature, 38.8°; 1.0 quinin. This was suggested to the patient as opium, and he slept-for the first time in ten days-for three hours.

12 m.: Temperature, 39.4°; pulse, 148. Continues to take nourishment well. In addition to 5 to 6 liters of milk, eggs, ham, bread, and 2\ pints of wine a day.

6 p. m.: Temperature, 38.7°; pulse, 124. In the evening, 0.5 quinin.

October 17: Feels considerably better. Temperature, 38.7°; pulse,


8 a. m. : 1.0 quinin. Sleep.

Evening: Temperature, 38°; pulse, 104; hemoglobin, 30 per cent.; 0.5 quinin.

October 18: Highest temperature, 38.3°. General condition much better.

October 19: Temperature normal.

October 21: Quickly progressing convalescence. Hemoglobin, 34 per cent. The nucleated erythrocytes have disappeared. The patient had complained for some days of visual disturbances.

October 24: Ophthalmoscopic examination of the eyes showed bilateral retinal hemorrhages. Hemoglobin, 42.5 per cent.

October 30: The purple reddish discolorations of the retina have taken on a whitish color. Visual power restored. Hemoglobin, 45 per cent.

October 31: Temperature over 39°. The general condition but little disturbed; only appetite less.

November 1: Temperature scarcely exceeded 38°. Hemoglobin, 43 per cent.

November 2: In the morning, several attacks of bilious vomiting. Temperature, 40°. In the unstained blood a few very small ring formed parasites. Evening temperature, 38°; 1.0 quinin.

November 3: Temperature, 38.2°.

9 a. m. : Temperature, 37.6°. In the blood, no more parasites.

10 a. m. : 1.0 quinin.

November 4: Morning, 1.0 quinin. Remained apyretic for the first time.

November 7: Hemoglobin, 53 per cent. In the course of November the patient had one other paroxysm, with a rise of temperature to 40°. Since only one generation of parasites was present, the infection was definitely cured by 1.0 quinin. Subsequently the patient took, every five days, 0.5 quinin, and remained apyretic until he returned to Germany in December.