Sbction IV., 1906. [ IS ] Trans. R. S. C. 



II. — Sleeping Sicl'ness. 

 By Sir James Graxï, K.C.M.G. 



(Read May 22nd, 1906.) 



At present in England, the subject of Tropical medicine, is attract- 

 ing widespread attention, and undoubtedly experimental medicine is 

 responsible for the greatest advances which have come to light, vsdthin 

 the past few years. The discoveries of Novy and M/cNeal, are of much 

 importance, the first in fact to obtain pure cultures of protozoa, main- 

 taining trypanosomas of different species, alive. The recent discovery 

 during the past year, of protozoal parasites in the blood of different 

 animals, in addition to many new species of trypanosoma, is of much 

 interest, and more particularly owing to the close affinity of these dis- 

 coveries, with Sleeping Sickness. So far as known, the first to observe 

 " Sleeping Sickness,^' was Winterbottom, who wrote a brief paper in 

 1803, giving an account of the native Africans in the neighbourhood of 

 Sierra Leone. The next reports of importance were those of Dinnon- 

 tier and Santelli in 1868, buij by far the most important and accurate 

 account, is by Corre, who studied the disease, in the natives of Senegam- 

 bia. In 1891 MacKenzie recorded a case of " Sleeping Sickness" in the 

 London Hospital, and in 1900 Manson, made a special record of two cases 

 in Charing Cross Hospital, sent from " The Congo," by Dr. Grattan 

 Guinness : Dr. Mott> the able neurologist of Charing Cross, worked out 

 aarefuUy, the pathological history, and defined the lesion as one of the 

 nature of " meningo-encephalitis." Until within a limited period the 

 geographical distribution of " Sleeping Sickness," was limited to West 

 Africa. For some years, it has also been known in The Congo, as well 

 as in several of the West Coast areas. In 1900 Cook discovered " Sleep- 

 ing Sickness " in Uganda, since which date the disease has spread widely 

 towards the north shore of Victoria Nyanza Lake. 



From the various reports of local observers, the epidemic area of 

 " Sleeping Sickness," is confined to parts of Equatorial Africa. On the 

 Upper and Lower Congo, the disease has been noted in epidemic form, 

 large numbers of the population falling victims to its influence. 



As to the cause of this disease, many hypotheses have been pro- 

 pounded in explanation, such as an intoxication of food, animal parasites 

 and bacteria. Since November 1902, Castellani frequently observed 

 " trypanosoma " in " Sleeping Sickness," in fact he discovered try- 

 panosoma in the cerebro spinal fluid of 20 out of 31 patients. Accord- 



