1906.] of Gambia Fever and of Sleeping Sickness. 101 



hyperplastic nature, and the reddish ones showed sinus formation, extreme 

 congestion, and often haemorrhages. 



The lungs were always very congested, with sometimes subserous 

 haemorrhages in the lower lobes. Small haemorrhages were found in 

 61 cases in the pleurae. 



The livers were always extremely congested, and were very soft in texture, 

 and showed extensive parenchymatous degeneration, and often fatty infil- 

 tration and degeneration. The vessels were very dilated and distended, and 

 often showed proliferation of their endothelium. 



The stomach in 13 cases was ulcerated ; generally one small ulcer filled 

 with clot was found, but sometimes as many as three or four. They were 

 always found on the greater curvature. In two cases death occurred from 

 perforation. 



There was generally a diffused congestion of the lining membrane of the 

 intestines, and on the peritoneal surface ecchymoses dotted about, either 

 singly or in groups, were often found. The kidneys were congested, and had 

 always macro- or micro-scopical haemorrhages. 



The spleen in every case was enormously enlarged, with great congestion 

 of the pulp, and considerable hyperplasia of the follicles. There was generally 

 proliferation of the endothelium of the distended vessels, and a great deal of 

 phagocytosis of red blood corpuscles and trypanosomata. 



The bone marrow (femur) was profoundly altered, having the appearance of 

 red marrow. It was very cellular, with scarcely any fat, and there was 

 always considerable phagocytosis, and many nucleated red corpuscles. 



6. Conclusions. 



From the above summary of 211 experiments, extending over a period of 

 nearly three years, it will be obvious that the tentative deductions which I 

 made in my Preliminary Note from the few experiments therein recorded, 

 that Gambia Fever and Sleeping Sickness are two distinct diseases, cannot 

 be maintained. 



This extended series of experiments and observations go to show that each 

 of these two strains of trypanosomata has produced two different effects 

 in the same class of animals, under conditions of which we at present know 

 nothing ; and that these effects are alike for the two organisms ; and that 

 the trypanosomata found in these two types of disease are one and the same 

 organism, modified by passage from man through monkeys to rats, and 

 perhaps in the strains I have used, by transplantation into animals of, and 

 in, another country. 



