238 Dr. F. W. Mott. Brains of Men and Animals [Mar. 14, 
therefore, that Bara Risgalli, had he lived longer, would have developed 
Sleeping Sickness, for in some places a few of the vessels showed slight 
lymphocyte proliferation in the surrounding lymph spaces; but even this 
is not conelusive evidence, for I have found the same in chronic diplo- 
streptococcic meningitis. | 
There is another man, Tabula, whose glands, removed intra vitam, I have 
examined, and which showed exactly the same changes as Bara Risgalli, and 
who, I understand, has similar trypanosomes in the blood, and general 
glandular enlargement, but has not yet developed any signs of Sleeping 
Sickness. It will be interesting to see what becomes of him. 
It has been shown that the cerebro-spinal fluid in Sleeping Sickness 
always contains trypanosomes, and likewise the juice of the lymphatic glands 
by puncture during life. On examination of sections of the glands in a 
number of these cases, in which active trypanosomes had been found during 
life, I observed only rarely a body which I could definitely call a trypano- 
some, therefore, it is not surprising that I was unable to find, after very 
careful search of many hundreds of sections, any body which I could 
definitely recognise as a trypanosome in the meningeal peri-vascular cell 
infiltration of the central nervous system. Yet, as the coloured drawings 
show, not only did one see similar cells and products of chronic inflammatory 
change in the peri-vascular lymph spaces, but also similar products of 
degeneration and similar staining chromatin bodies and bits like those seen in 
the lymphatic glands, which we have reason to believe may be products of 
degenerated trypanosomes. Moreover, I have occasionally seen a macro- 
nucleus with its accompanying micro-nucleus amidst the cells of the peri- 
vascular infiltration. In the lymphocytes themselves, in a chronic case in 
which I could discover no diplococcal infection by Gram’s method, I have 
found deep staining bodies, oval or round in shape, but I am unable to affirm 
what they are. 
If the trypanosomes are continually being destroyed, as they seem to be 
by the cells, it is not surprising that more evidence of their existence is not 
seen. It is remarkable in transections of the blood vessels in very chronic 
cases, to observe how few are the polymorpho-nuclear leucocytes, and how 
numerous the small and large mono-nuclears, and apparently these get into 
the peri-vascular spaces. 
Examination of tissues of other organs from cases of Sir Patrick Manson’s 
showed that not only the brain and glands are affected, but serous membranes 
and organs of the body, by this lymphocyte infiltration around the vessels, 
although to a much less degree. 
