233 



Pathological Report on the Histology of Sleeping Sickness and 

 Trypanosomiasis, with a Comparison of the Changes Found 

 in Animals Infected with T. Gambiense and other Trypano- 

 somata. 



By Anton Breinl, M.U.Dr. (Prague), J. W. Garret International Fellow, 

 Liverpool School of Tropical Medicine. University, Liverpool. 



(Communicated by Professor R. Boyce, F.R.S. Received April 8, — Read 



May 11, 1905.) 



Three cases of Sleeping Sickness and one case of Trypanosomiasis dying in 

 Liverpool have been histologically examined. The central nervous system of 

 the Sleeping Sickness cases showed the changes described by different 

 observers, Mott, Low, the Portuguese Commission and others. One case 

 exhibited an intra-pial haemorrhage of the spinal cord, extending from the 

 sixth cervical segment to the third thoracic segment, about 7 mm. broad. In 

 another case there occurred four larger haemorrhages, besides numerous 

 smaller ones, in the grey substance, chiefly affecting the posterior cornua and 

 the thoracic part of the cord. Microscopically the brain and spinal cord 

 showed small celled infiltration around the vessels, consisting for the most 

 part of lymphocytes, some plasma cells and phagocytes, between which were 

 a varying number of red cells in different stages of disintegration. The 

 intima of the vessels showed a proliferation of the endothelial cells. Red 

 and white blood corpuscles were often seen in the vessel walls. Here and 

 there the blood vessels were filled with white blood corpuscles resembling a 

 thrombosis. 



It is most striking that the small celled infiltration is much more marked 

 in the grey substance of the nervous centres, especially in the large 

 grey ganglia, than in the peripheral parts. Very numerous capillary 

 haemorrhages of different sizes were present in these situations. Infiltration 

 around the vessels of the membranes and in the tissues of the pia and 

 arachnoidea was observed. Around the infiltrated vessels degeneration 

 of the fibres and an excess of glia cells were seen, sometimes exhibiting the 

 picture of red softening. The ganglia cells showed an irregularly 

 distributed degeneration, central and peripheral chromatolysis and also 

 partial pyknosis. 



Signs of inflammation and small celled infiltration in the endu- and peri- 



