seems to occur most frequently and most distinctly in the earlier stages of the infection. Some of the patches may extend to six inches or even to a foot in diameter, their margins fading off insensibly into the surrounding normal skin. Sometimes the erythema takes the form of large rings, occasionally complete, more frequently interrupted and irregular. Erythema nodosum sometimes occurs. Pressure or any irritation of the skin gives rise at once to transient congestion from vaso-motor paralysis of the skin capillaries.
In some of the lower animals a usual feature is redema of certain parts of the body, especially the sheath of the penis, the under surface of the abdomen, and the neck. Similar though less extensive œdemas ccur in man, in whom they are most apparent about the face and about the site of the erythema. In many instances there is a general fullness of the features, which, together with concomitant flushing of the face, is apt to convey a false impression of sound health.
Neuralgic pains, cramps, formication, and paræsthesiæ of different kinds are not uncommon. In two of my European cases recurring orchitis, accompanied by an increase of parasites in the blood, was a feature. Painful local inflammatory swellings, which after a time subside without suppuration, I have seen in three cases; periostitis of tibiae once. Irido-cyclitis and choroiditis are sometimes met with.
In most cases the spleen is enlarged, sometimes enormously enlarged, the swelling fluctuating with the fever. The liver also may be enlarged. As the patients affected with trypanosomiasis are usually the subjects of malarial disease, it is not always possible to say whether the splenic enlargement is entirely or partly attributable to the trypanosome.
According to Greggio, trypanosoma infection is not as a rule transmitted to the fostus; nevertheless, the abortion-rate in the infected is increased from the normal 7 per cent, in Congo natives to 31.7 per cent., and the infant mortality from 29 per cent, to 50 per cent.
