1904.] 



Sleeping Sickness in Uganda. 



513 



Sex. Age. 



Benjamiui 

 Esaka 

 Waiswa . . 

 Kidorme .. 

 Zebuganza 

 Budara . , 

 Kimbra . . 

 Matasa .. 

 Seera 

 Warosansa 

 Katola 

 Koagoflfa .. 

 Kitaroma 

 Nakaiba .. 

 Musa 

 Diwarana 



Male 



Female 

 Male 



28 

 28 

 10 

 20 

 40 

 22 

 30 

 24 

 25 

 32 

 25 

 30 

 20 

 8 

 20 

 14 



''Sasr' Trypanosoma. 



1st stage 



1st 



1st 



2nd 



1st 



2nd 



2nd 



1st 



2nd 



2nd 



1st 



1st 



1st 



1st 



1st 



1st 



Present 



Absent 

 Present 



unfortunately died before the trypanosomes had been discovered in 

 his blood. 



But there is another fluid in the body which is more easily 

 examined than blood for such a small parasite, and that is the 

 cerebro-spinal fluid. 



This cerebro-spinal fluid is a clear transparent fluid, exactly 

 resembling water in outward appearance, which fills the various 

 cavities of the brain, and surrounds the spinal cord so as to prevent 

 damage to these delicate organs. It is easily obtained by introducing 

 a hollow needle between the vertebrae in the lumbar region. Ten to 

 fifteen cubic centimetres of the fluid are drawn off", which is then 

 centrifuged and the sediment examined. As there are few or no red 

 corpuscles in the fluid to interfere with the vision, naturally the 

 actively moving trypanosomes are more easily detected. 



I now give a table showing the result of the examination of the 

 cerebro-spinal fluid cases of sleeping sickness. 



Here, as you see, forty cases have been examined and the 

 trypanosomes found in every case. This is rather a suggestive fact, 

 and it begins to appear probable that these parasites may have some 

 causal relationship to the disease. 



But it may be that this trypanosome is a mere accidental con- 

 comitant of the disease, living in the blood and cerebro-spinal fluid 

 without afi'ecting the health, much in the same way as the rat 

 trypanosome lives in rats, or the nagana trypanosome in the wild 

 animals. So it may be that natives suffering from other diseases 

 also harbour these trypanosomes in their cerebro-spinal fluid. To 

 find if this were so we must examine the cerebro-spinal fluid of 

 natives who come into hospital for other complaints than sleeping 

 sickness. This was done, with the result that none of the patients in 



