1272 



THE AFRICAN TRYPANOSOMIASES 



may be seen. The leucocytes are normal in number, as a rule, with 

 an increase of mononuclear cells, while there may be a terminal 

 polymorphonuclear increase before death. 



In fresh preparations the red cells are not evenly distributed, nor 

 do they form rouleaux, being generally clumped into masses. This 

 phenomenon of auto-agghdination was first' noticed by Kanthack, 

 Durham, and Blandford in the lower animals inoculated with 

 nagana; and in man, in cases of sleeping sickness, by Dutton, Todd, 

 and Christy, and may be of diagnostic value. The phenomenon of 

 auto-erythrophagocytosis has occasionally been noted. 



The chemical examination of the blood in trypanosome infections 

 of animals has been performed by Takinioff and by Nierenstein, 

 the latter of whom found, by Moore and Wilson's method of testing 

 the alkalinity of the ash, that the acidity of the blood was increased, 



Fig. 641. — Temperature Chart of a Case of Sleeping Sickness. 

 (From Low and Castellani Reports of the Royal Society on Sleeping Sickness.) 



probably due to the formation of amido-acids, either secreted by 

 the parasites or produced by their action upon the proteids of the 

 serum. The acidity was tested by phenolphthalein and Congo red, 

 and the alkalinity, which remained fairly constant, was tested by 

 dimethyl-amido-azo-benzol. 



The animals were infected with C. brucei and C. equiperdum, but 

 so far no observations have been made on human blood. 



Urine. — ^No abnormality is found in the urine, but the reaction, 

 amount of phosphates, etc., of course, varies with the food taken. 

 In native patients it is very often alkaline. 



Sexual desire and menstruation are normal at first, but later are 

 lost. The lymphatic glands throughout the body, but especially 

 those of the neck, and more especially those of the posterior triangle, 

 are enlarged. It is to be noted, however, that in the last stages 

 the lymph glands often undergo a process of fibrosis, becoming 



