363 



become anaemic, complete paraplegia sets in, and 

 death in two to ten months. 



Trypanosomes are most easily found in the 

 ' plaques,' with difficulty in the blood. 



Post -Mortem. — There is inflammation of the 

 urogenital mucosa, and in two cases areas of 

 softening have been found in the spinal cord. 

 Ruminants are refractory (to T. brucei they are 

 very susceptible). Dogs which have been immu- 

 nized against T. equiperdum yet succumb to 

 T. brucei, so that Dourine and Ngana are distinct. 



6. T. gambiense (Dutton).— This, the first 

 human trypanosometo be described, was discovered 

 by Button in the blood of a European in the Gam- 

 bia. The clinical symptoms of the case were : — 



(1) Irregular relapsing fever. 



(2) Oedema, especially about the ej^es. 



(3) Congestion of the skin. 



(4) Erythematous patches, associated with 

 thickening of the skin. 



(5) Increased pulse and respirations. Loss 

 of flesh. 



The trypanosomes are generally scanty in the 

 blood, and it may be necessary to centrifugalize 

 and examine the leucocytic layer. 



N.B. — Europeans in an area where trypanosomiasis (or 

 sleeping sickness) is endemic in the native population, may be 

 infected with trypanosomes and show none of these signs, at 

 least at first, except, perhaps, a daily rise of temperature in 

 .the evening. Examine repeatedly and carefully Europeans with 

 an irregular intermittent temperature on which quinine has no 

 effect. 



TRYPANOSOMIASIS (SLEEPING SICKNESS) 



In igo2 Castellani found a trypanosome in 

 the cerebro-spinal fluid of a case of sleeping 



