SLEEPING SICKNESS 659 



Against this is the fact that the Uganda sleeping sickness has 

 only appeared during the last three years [that is, previous to 

 1903], and that during that time no change of food has taken 

 place among the natives. 



Parasites. — Manson suggested the Filaria perstans as the 

 cause of the disease. This has been disproved by the observa- 

 tions of Low, who finds that in British Guiana, where this 

 parasite is common, there is no sleeping sickness, while in 

 Kavirondo the opposite conditions are present. Forbes con- 

 sidered that the embryo of Rhabdonema strongyloides was the 

 cause of the disease. This parasite penetrates the intestinal 

 mucous membrane (Tessier), reaches the general circulation, 

 and remains in the blood-vessels of the brain. Ferguson looked 

 upon the Ankylostoma duodenale as the cause. As disproving 

 this theory, it is found that the administration of appropriate 

 anthelmintic remedies cures the patient of this parasite, but 

 does not in any way permanently check the course of sleeping 

 sickness. 



Bacteria. — Cagigal and Lepierre in 1897 isolated a bacillus 

 from the blood of a patient suffering from sleeping sickness ; 

 but their statement that this microbe, injected into animals, 

 caused the disease was not afterwards confirmed. Marchoux 

 believed the disease to be due to Frankel's diplococcus, for the 

 following reasons : He found Frankel's diplococcus, post 

 mortem, in the pericardial fluid of a case of sleeping sickness 

 complicated by pericarditis. In another case, complicated by 

 chronic rhinitis and suppuration of the frontal sinus, the nasal 

 secretion was found to contain this microbe. Marchoux also 

 noticed that sleeping sickness occasionally occurred in people 

 who had had pneumonia. 



Recently, the Portuguese Commission have described a 

 diplostreptococcus constantly found, post mortem, in the cerebro- 

 spinal fluid in cases of this disease. They have also often 

 found the same microbe during life in patients suffering from 

 sleeping sickness, in the cerebro-spinal fluid obtained by lumbar 

 puncture. They state that this organism will not grow on 

 gelatine, and not readily on the other common culture media. 

 More recently still, however, the Portuguese Commission 

 have stated that their organism will grow on gelatine and the 

 other common culture media. 



Dr. Broden, of the Leopoldville Bacteriological Laboratory, 



