SLEEPING SICKNESS 



Bv G. D. PARKER, M.B. (Lond.) 



The disease " sleeping sickness," more correctly African 

 meningoencephalitis, has for more than a hundred years been 

 known to occur in West Africa. Until quite recently it 

 ranked as one of the curiosities of medicine, but the wide- 

 spread havoc that it has caused in the last ten years has made 

 inquiry into the origin and course of the disease imperatively 

 necessary. The history of this inquiry, illustrating as it does 

 the modern method of investigation in such problems, will 

 be of interest to more than purely medical readers who may 

 not have the time at their disposal to read the admirable 

 Report of the Sleeping Sickness Commission, to be found in 

 the Transactions of the Royal Society from 1903 to 1907. 



History of the Disease. — Winterbottom first observed sleeping 

 sickness, and wrote a paper, " An Account of Native Africans in 

 the Neighbourhood of Sierra Leone," in 1803. In 1868 Dumon- 

 tier and Santelli wrote independent papers on the disease. 

 Guerin wrote on it in the following 3^ear. The first complete 

 and fairly accurate account was written by Corre, amongst the 

 natives of Senegambia. 



It has been stated that sleeping sickness has been observed 

 among negro slaves imported to the West Indies, and also in 

 Brazil ; but the evidence is doubtful. 



In 1 891 there was a case of sleeping sickness in the London 

 Hospital, and in 1900 two cases in the Charing Cross Hospital, 

 sent from the Congo. The pathology of these cases, with their 

 pathological history, was worked out by Mott, and the disease 

 was found to be a meningo-encephalitis. More lately this 

 malady has become commoner in various parts of Africa. 



Geographical Distribution. — Sleeping sickness is endemic only 

 in parts of equatorial Africa. Until very recent years it was 

 limited to West Africa, from Senegal in the north to San Paolo 

 de Loanda in the south. It has been known for many years on 

 the Congo, has recently spread up the Congo to Stanley Falls, 



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