CHAPTER XXI 

 SLEEPING SICKNESS 



TRYPANOSOMA GAMBIEUSE (DUTTON) TRYPANOSOMA RHODESIENSI 

 (STEPHENS AND FANTHAM) 



SLEEPING sickness, African lethargy, Maladie du sommeil, 

 Schlafkrankheit, or human trypanosomiasis is a specific, infectious, 

 endemic disease of equatorial Africa characterized by fever, lassi- 

 tude, weakness, wasting, somnolence, coma, and death. The first 

 mention of the disease seems to have been made by Winterbottom.* 



Sir Patrick Mansonf says that "For upward of a century students 

 of tropical pathology have puzzled over a peculiar striking African 

 disease, somewhat inaccurately described by its popular name, the 

 sleeping sickness. Its weirdness and dreadful fatality have gained 

 for it a place not in medical literature only, but also in general 

 literature. The mystery of its origin, its slow but sure advance, 

 the prolonged life in death that so often characterizes its terminal 

 phases, and its inevitable issue, have appealed to the imagination 

 of the novelist, who more than once has brought it on his mimic 

 stage, draping it, perhaps, as the fitting nemesis of evil-doing. The 

 leading features of the strange sickness are such as might be pro- 

 duced by a chronic meningo-encephalitis. Slow irregular febrile 

 disturbance, headache, lassitude, deepening into profound physical 

 and mental lethargy, muscular tremor, spasm, paresis, sopor, ulti- 

 mately wasting, bed-sores, and death by epileptiform seizure, or by 

 exhaustion, or by some mtercurrent infection. 



"In every case the lymphatic glands, especially the cervical, 

 are enlarged, though it be but slightly. In many cases pruritus is 

 marked. In all, lethargy is the dominating feature. 



"In some respects this disease, which runs its course in from 

 three months to three years from the oncoming of the decided symp- 

 toms, resembles the general paralysis of the insane. It differs from 

 this, however, in the absence, as a rule, of the peculiar psychic 

 phenomenon of that disease. There are exceptions, but generally, 

 though the mental faculties in sleeping sickness are dull and slow 

 acting, the patient has no mania, no delusions, no optimism. So far 

 is the last from being the case, that he is painfully aware of his con- 

 dition and of the miserable fate that is in store for him; and he looks 

 as if he knew it." 



* "An Account of Native Africans in the Neighborhood of Sierra Leone," 1803. 

 t "The Lane Lectures for 1905," Chicago, 1905. 



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