456 On the Lymphatic Glands in Sleeping Sickness. [May 5, 



The authors also examined the cervical lymphatic glands of the five 

 natives suffering from trypanosomiasis who have been under observa- 

 tion for the past year, and found actively motile trypanosomes in the 

 liquid withdrawn from the glands in all of them. Tabula, one of these 

 patients, is employed in the hospital, and the dispenser reports he is 

 getting very stupid. 



The lymphatic glands were also examined for streptococci by staining 

 and culture, but in every case were found to be sterile. Some of the 

 cases, the glands from which were examined for streptococci, were very 

 far advanced. The streptococcus invasion must, in the opinion of the 

 authors, be a very late one and only occur shortly before death. 



Observations made upon the blood show a constant increase in the 

 percentage of lymphocytes, but the total leucocytes are not increased. 



The authors consider that these observations throw a new light 

 upon the glandular enlargements which have been so constantly 

 noticed in sleeping sickness, and that the disease is essentially a 

 polyadenitis brought about by the arrest of the trypanosomes in the 

 glands where many of them are destroyed, but whence some escape 

 from time to time into the blood stream and thus occasion the increase 

 which has been observed in the peripheral circulation. 



They regard their observations upon the presence of trypanosomes 

 in number ,in the lymphatic glands of both early cases of trypano- 

 somiasis and advanced cases of sleeping sickness, as affording important 

 evidence of the unity of these diseases, and further proof that the 

 trypanosomes are the essential cause of sleeping sickness. 



