235 
Note upon the Examination, with Negatwe Results, of the Central 
Nervous System in a Case of Cured Human Trypano- 
somiasis. 
By FrepErick W. Mort, M.D., F.R.S. 
(Received October 22,Read November 3, 1910.) 
This is the first case in which “a chance has occurred of examining 
a cured case of human trypanosomiasis post mortem,” according to the 
statement of C. A. Wiggins, the Acting Principal Medical Officer of the 
Uganda Protectorate, who has kindly forwarded me the tissues for micro- 
scopic examination. 
Summary of the History of the Case.—Narain Singh, a Sikh, belonging to 
the 4th K.A.R. (aged 30 at death), was found to be suffering from trypano- 
somiasis in June, 1905, and received treatment with inorganic arsenic. The 
previous history as far as ascertainable, compiled from extracts of reports and 
history sheets, is published in the full account, but, in brief, it may be 
assumed that the drug was given intermittently for 18 months or more, 
and pushed till toxic symptoms of neuritis, mental dullness, etc., rendered 
further energetic treatment impossible ; trypanosomes were then no longer ' 
obtained by puncture of the glands. Untortunately there is no note of 
lumbar puncture having been performed until a few months before death, 
therefore we do not know whether invasion of the sub-arachnoid space ever 
occurred either before or after the treatment. But it is probable that 
trypanosomes were never present in the cerebro-spinal fluid, for if they were, 
the symptoms of ‘Sleeping Sickness would, in all probability, have come on, 
in spite of treatment by atoxyl. Sir David Bruce, in December, 1908 (that 
is three and a half years after the trypanosomiasis had been discovered), 
saw this man, and stated that he appeared to be in excellent health. A year 
.later he was seen by Captains Hamerton and Bateman, who reported no 
symptoms of Sleeping Sickness. They made a very careful investigation of 
the blood, both by microscopic examination and by experimental injection 
into monkeys; the results were negative. In June, 1910, lumbar puncture 
was performed, and 17 c.c. of fluid withdrawn; the centrifuged fluid showed 
no lymphocytosis or trypanosomes ; and injection of the fluid into a monkey 
was followed by negative results. The patient was attacked with pneumonia 
in August, 1910, and died three days after admission to the hospital. At 
the post-mortem examination grey hepatisation of the whole right lung was 
discovered. Beyond fibrosis and induration of the cervical and inguinal 
