144 



DISEASES DUE TO PROTOZOA 



tion very common in fresh blood films. There is often tremor of the 

 tongue and fingers. 



They decline treatment as a rule in this stage because treatment is 

 more painful than the disease. 



'fe^ 



Child with trypanosomiasis showing cedematous swellings of the eyelids. 



THE CEREBRAL STAGE. 



In the Sleeping Sickness stage death is inevitable, but when the 

 former stage ends and this one begins is not accurately known. 



This stage lasts from a few weeks in acute cases to a few months 

 in chronic cases. Some have lived for jears, and have then died from 

 some intercurrent disease. 



One notices a change in the habits of the jjatients, the disposition 

 is modified more often for the worse, they become apathetic, dull, there 

 is disinclination for exertion, they become careless, dirty, find it difficult 

 to walk, become indifferent to most things, and forget to masticate the 

 food that lies in their mouths. 



Sleep is often excessive, but it is more frequently a lethargic con- 

 dition thai is manifested. There are fine tremors of the tongue, hands, 

 arms, legs, and even of the abdomen. There is a peculiar gait, a 

 difficultv in raising the feet from the ground, he shuffles along or 

 throws his feel outwards in walking. 



There is no jDaralysis as a rule; the superficial reflexes are normal, 

 the deep reflexes are increased and then lost. Delusions and mania 

 are fairly coiumon. Romberg's sign is sometimes present. Later 



