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BLOOD EXAMINATION AND ITS

severe and sudden cramps in the legs and arms, any alteration of position bringing on the pains. After 10 days' cramps he lost the use of his legs, went into hospital, and was invalided home. On arrival in England the condition remained stationary. He had taken quinine, grs. v., twice weekly until arrival in hospital at Tropical School. On admission, 9th October 1906, temperature 99.6°. Spleen and liver just palpable. Patient unable to walk on account of peripheral neuritis. Pain on pressure over nerves of lower extremities, especially posterior tibials. Knee jerks lost. No loss of tactile sensation, but great feeling of numbness. Pupils reacted to light and accommodation. On 14th October temperature rose to 103°. Pulse 110, and a quotidian intermittent temperature set in, varying between 104° and 97°. Blood examined and showed crescents. Quinine, grs. ix., intramuscularly administered three days running and temperature became sub-normal and the peripheral neuritis rapidly began to clear up, so that patient was able to step on to a chair and step down backwards. No œdema present at any time nor affection of the heart suggesting beri beri; patient had been a total abstainer since March 1906 and moderate before;