CHAPTER XLV 



THE AFRICAN TRYPANOSOMIASES 



General remarks — The sleeping sicknesses — The trypanosome fevers — 



References. 



GENERAL REMARKS. 



The human African trypanosomiases include two different clinical 

 conditions — viz. — 



A. The sleeping sicknesses characterized by the fact that we 

 definitely know that the preliminary fever leads to meningo-en- 

 cephalitis and meningo-myelitis. 



B. The trypanosome fevers characterized by the fact that we do 

 not know that in these cases the disease will end in meningo- 

 encephalitis and meningo-myelitis. 



Before Castellani discovered a trypanosome in sleeping sickness", 

 Ford and Button had demonstrated that ' Gambia fever ' was due 

 to a trypanosome. After this discovery this disease was named 

 ' trypanosome fever,' and was considered to be quite distinct 

 from sleeping sickness. After Castellani had found a trypanosome 

 in sleeping sickness the two diseases, trypanosome fever and 

 sleeping sickness, were at the time judged to be covered by the 

 one name ' sleeping sickness.' Recently, however, Lanfranchi's 

 laboratory infection with a trypanosome has lasted for more than 

 seven years, and there is no sign of meningo-encephalitis, as may 

 be judged inter alia by the excellent papers which the distin- 

 guished professor produces. In fact, judging by the symptoms 

 exhibited by Lanfranchi, which resemble those found in the trypano- 

 somiases of animals, it seems very doubtful whether he will ever 

 show signs of what we clinically call ' sleeping sickness.' Further, 

 the organism with which he is affected appears to be of the Evansi 

 type, a form known to be in his laboratory when infection took 

 place. 



Under these circumstances, it appears to us to be useful to return 

 to the old name trypanosome fever for infections of man and animals 

 with those pathogenic trypanosomes which produce fever and 

 do not end in meningo-myelitis. At present those known in man 

 are the case of Professor Lanfranchi and the infection with a variety 

 of the Vivax type described by Macfie, both of which, in our 

 opinion, should remain under this denomination until it is proved 

 that they belong to the sleeping sickness group. 



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