HUMAN TKYPANOSOMIASIS 143 



jections given every alternate day for two weeks, and 

 after an interval of one week a second two weeks' course, 

 have been permanently effective. In others the trypano- 

 somes have returned, but yield readily to atoxyl. A 

 combination of this form of treatment with intramuscular 

 injections of atoxyl appears to give the best results. Even 

 the Rhodesian form of the disease can be controlled by 

 this treatment, but no permanent good result has yet been 

 obtained. 



Nursing. No special precautions are required. The 

 disease is a chronic one and good feeding is necessary. 

 On account of the cardiac condition sudden movements 

 or exertion on the part of the patient must be discouraged. 

 When the general condition of the patient permits it he 

 should be allowed to live an ordinary healthy life. But 

 over-fatigue and any risk of intercurrent disease must 

 be carefully guarded against. 



When taking atoxyl or any other preparation of arsenic, 

 any digestive disturbance, such as nausea, vomiting, or 

 abdominal pains must be carefully noted. Any com- 

 plaint of dryness of the mouth, and pain or irritation of 

 the eyes, must also be reported. 



Increasing muscular tremor, headache, and disturbed 

 sleep are premonitory signs of the onset of sleeping 

 sickness. When this supervenes, all that can be done is 

 to feed the patient at regular intervals, and to keep him 

 clean, warm, and comfortable. There is no object in 

 endeavouring to prevent him from sleeping. 



Etiology. There are certain points of analogy between 

 trypanosomiasis and some cases of syphilis. In both 

 there is a latent period followed by a more or less 

 marked febrile stage, and associated with glandular en- 

 largement and cutaneous eruptions and terminating in 

 the formation of diffuse lymphoid growths around the 

 cerebral vessels. 



In some cases of trypanosome infection there is a 

 definite scar, the result of a bite from an insect, which 

 was painful for some time, and this rnay be considered 



