APPENDIX B 289 



the legs, indicating a definite implication of the motor 

 centres. By this time the patient has taken to bed, 

 or he lies about in a corner of his hut, indifferent to 

 everything going on about him, but still able to 

 speak and take food if brought to him. He never 

 spontaneously engages in conversation, or even asks 

 for food. As torpor deepens he forgets even to 

 chew such food as is given to him, falling asleep, 

 perhaps, in the act of conveying it to his mouth, or 

 with the half- masticated bolus still in his cheek' 

 (Manson). 



Later on he begins to lose flesh ; convulsions and 

 temporary local paralysis occur ; bed-sores tend to 

 form and spread rapidly. As the lethargy becomes 

 more continuous, he wastes quickly from lack of 

 nourishment, and the end is brought about either by 

 coma or by the increasing weakness. In some cases 

 all or most of these symptoms may be seen, but 

 different cases exhibit a wide range of different 

 symptoms, and it is impossible to define the exact 

 course of the disease. 



The mortality of the disease must be reckoned as 

 100 per cent. It is possible — but there is no definite 

 knowledge on this point — that recovery may take 

 place in the very early stages of trypanosomiasis, but 

 when once the sleeping-sickness stage of the disease 

 has been reached, it is probably invariably fatal. I 

 have already drawn attention (see Chapters III. and 

 XVI.) to the appalling destruction of human life 

 that has taken place in the last few years in a corner 

 of Uganda and one small district of the Congo Free 

 State ; but this represents but a fraction of the havoc 

 which has been wrought in Central Africa by sleeping 

 sickness. 



Not longer ago than September, 1907, Professor 

 Koch, in reporting on his investigations made in Lake 



19 



