1 906.] Nervous System in a Case of Chronic Dourine, etc. 7 



Dourine, but I have now examined quite a number of posterior spinal 

 ganglia in Sleeping Sickness cases, and I have never failed to find some 

 change, never sufficient, however, to produce cell destruction, such as is 

 found in Dourine. The most intense change I have met with is shown in 

 Photomicrographs 7 and 8, and this in no way differs, except in degree, from 

 that seen in Dourine. 



Laveran and Mesnil mention that dislocation and fractures may occur in 

 Dourine, and we know that spontaneous dislocation and fractures are met 

 with in tabes dorsalis, a disease in which the posterior roots and posterior 

 columns of the spinal cord undergo degenerative atrophy. 



The membranes at the base of the brain of this animal, which died of 

 Dourine, seemed thicker than normal. On microscopic examination sections 

 of the peduncles and interpeduncular structures exhibited a subpial and 

 septal neuroglia proliferation very similar to that seen in the lumbar 

 region of the spinal cord. I observed, however, but little or no lymphocyte 

 infiltration. 



Comparison of the Changes in the Tissues of Animals Dying after Inoculation 

 with Trypanosoma Gambiense, also with the Tissues of Human Sleeping 

 Sickness, with those met with in the Case of Dourine above described. 



The examination of the tissues of the spinal cords of a number of cases of 

 Sleeping Sickness, especially of several chronic cases in which there was no 

 terminal or secondary infection from suppurating glands, shows a glia 

 proliferation in the spinal cord and throughout the nervous system similar to 

 that above described, and it may be remarked that the lymphocyte prolifera- 

 tion is not always in proportion to the glia proliferation. Moreover, in all 

 chronic cases there is a marked glia proliferation around the central canal 

 of the cord. 



Zururu bin Mza and Masake* were very chronic cases in which there was 

 a most extensive glia proliferation certainly not all due to secondary 

 degeneration, but caused by a chronic interstitial inflammatory extension 

 along the subpial septa and perivascular spaces {vide figs. 1 and 2, Plate 1) 

 without marked destruction of the intervening nerve fibres. 



" Cases of two monkeys inoculated with Trypanosoma Gambiense "f : — 

 (1) A monkey infected by fresh fly feeding, the animal dying eight months 

 later. No perivascular lymphocyte infiltration was discovered in the central 

 nervous system, but there was a very marked chromolytic change in the 

 ganglion cells of the medulla, also a considerable degree of acute glia cell 



* Vide 'Reports of the Sleeping Sickness Commission,' No. VI, pp. 270 and 234. 

 t Vide ' Reports of the Sleeping Sickness Commission,' No. VI. 



