10 



nyn go-cephalitis in which the seat of 

 She parasite in the brain and the lesions 

 prodiK-ed amply justified the recognition 

 of a nervous form of the disease, cas- 

 ting light on numerous obscure points 

 of the local nosology. 



This precludes the basing on sound 

 scientific reasoning of the denial of ner- 

 Tous forms of the disease, with distur- 

 bances affecting motility, intelligence, 

 speach etc. and the great number of cases 

 of paralysis, organic idiocy, aphasia, ob- 

 served in friafoma— infested regions ca- 

 ses which reproduce the symptoms of 

 thiose which were submitted to 

 post-mortem examination, and must con- 

 sequently be attributed to the same etio- 

 logical cause. As an additional confir- 

 mation of this way of thinking, experi- 

 ments made by EURICO VILLELA and 

 MAGARINOS TORRES elicited paralyses 

 in dogs and monkeys with the conse- 

 cutive finding of the trypanosome and 

 lesions in the central nervous system. 



Infantilism and other dystrophies 

 frequently seen in the regions where 

 the disease is endemic, I ascribe to 

 infection by Trypanosoma Cruzi, either 

 as a residual form from infection in 

 first childliood or what is still more 

 probable as a consequence of heredita- 

 ry infection. Are there any reasons wan- 

 ting for conviction? How but by logi- 

 cal deduction from facts has syphilis 

 been connected with infantilism? Trypa- 

 nosoma Cruzi like tlie tréponème is 

 foimd localised in tlie different organs of 

 the endocrinic system whose rôle in 

 the general phenomena of development: 

 OS no longer contested. In the adrenals 

 of man and of experimentally infected ani 

 mais for instance, the trypanosome and 

 the lesions it produces have been amply 

 demonstrated. The same, as regards tes- 

 ticles, ovaries and the thyreoid gland. 

 And if these react, as has been obser- 

 ved, it is logic to admit the physio-pa- 

 thological consequences of these anato- 

 mical alterations. Here also recent 



experiments of EURICO VILLELA are 

 being of great value. E. VILLELA ob- 

 served new-born puppies of an infected 

 mother wither hereditary cephalitis and 

 trypanosomes. 



This subject, which needs detailed 

 explanation, cannot be gone into fully 

 in this work, in which I only desire to 

 outline the essential motives for my con- 

 victions concerning infantilism and other 

 dystrophies of the regions in which try- 

 panosomiasis is endemic. 



In the first phase of our work we 

 took trypanosomiasis to be the cause 

 of the endemic goitre of the regions 

 where the disease prevails. The reasons 

 we had were based, some of them on 

 the pathogenesis, others on the epide- 

 miology and geographic distribution of 

 trypanosomiasis. At first, the frequen- 

 cy of goitre or of a simple alteration in 

 the thyreoid with partial hypertrophy 

 of some of its lobes in patients with 

 other symptoms called my attention. 

 What further impressed us was the in- 

 filtration observed in all acute cases 

 and having the characters of myxœde- 

 ma. This was a constant symptom in the 

 the first phase of the infection, and was 

 to be considered as a myxœdematous in- 

 filtration peculiar to trypanosomiasis and 

 expressing the part the thyreoid played 

 in the pathogenic process. Posterior exa- 

 minations on acute cases showed tlie 

 seat of the trypanosome in the gland, 

 right inside the vesicular cells, and al- 

 so showed the inicial reaction-processes 

 that characterise the formation of the 

 stroma. Furthermore a prolonged obser- 

 vation of some patients, from the acute 

 phase, permitted to follow the progres- 

 sive development of the goitre, which in 

 some subjects attains a considerable size, 

 while in others it limits itself to hypertro- 

 phy, complete or partial, of the thyreoid. 

 The absolute absence of goitre in acute 

 cases and the existence of it in children 

 of the same age that might have got 

 mfected earlier were another argument 



