SLEEPING SICKNESS. 677 



wife of a missionary in upper Congo was bitten 

 by a tsetse-fly, and following an inflammatory re- 

 action at the seat of the bite, she developed and ran 

 a long course of trypanosomatic fever. After from a 

 year and a half to two years of remittent attacks 

 of fever, the organisms being found in the blood 

 repeatedly, she grew weaker, became somnolent 

 and died in a comatose condition. The anatomic 

 changes at autopsy were typical of sleeping sick- 

 ness. Some who are not quite willing to accept the 

 unity of the two diseases suggest that the sleeping 

 sickness may have been superimposed on trypano- 

 somatic fever. 



Assuming that the two conditions represent dif- 

 ferent stages of the same disease, we would have 

 to recognize trypanosomatic fever as the first stage 

 and the lethargy of sleeping sickness as the second. 

 If this proves to be correct the name of T. nepveui 

 should be retained for the organism and the other 

 names dropped (T. gambiense, T. hominis, T. 

 castellani) . 



It is believed that T. castellani is a distinct 

 species of trypanosome. It is hardly possible to as- 

 sociate it with nagana, since sleeping sickness and 

 nagana do not coincide in their distribution, and, 

 moreover, the morphology and pathogenicity of 

 T. castellani differ from that of T. brucei. The 

 former is not infectious for the "donkey, ox, 

 guinea-pig, dog, pup, goat and sheep" (Euata). 

 T. castellani is from 18 to 25 microns long and 

 from 2 to 2.5 broad. Its morphology in general 

 is like that of other trypanosomes, although there 

 are sufficient differences to establish its independ- 

 ence. Its motility is rather slow, and in contrast 

 to other trypanosomes it moves in the direction of 



