I26o 



THE AFRICAN TRYPANOSOMIASES 



THE SLEEPING SICKNESSES. 



Synonyms. — 'Sleeping dropsy, Negro lethargy, Morbus dormitivus. 

 French : Maladie du Sommeil. Portuguese : Doen9a de Sonno, Italian : 

 Malattia del Sonno, Letargia dei Negri. German : Afrikanische ScMaf- 

 krankheit, Trypanosomen Fieber. Native names are very numerous — 

 Lalangola, Laa La-negulo, N'tansi, Mongota, Konje Marree, Kaodzera, N'dulu, 

 Tula Manugina, Nelavare, Dadane, Toruahebue, etc. 



Definition. — ^The sleeping sicknesses are chronic specific fevers 

 caused by the trypanosomes Castellanella gambiensis Button, 1902; 

 Castellanella castellanii Kruse, 1903, spread by Glossina palpalis ; 

 and Castellanella rhodesiensis Stephens and Fantham, 1910, spread 

 by Glossina morsitans, characterized by an inflammatory condition of 

 the lymphatic system leading to a meningo-encephalitis which. shows 

 itself as dulness of the intellect, apathy, and lethargy, associated 

 with tremors and a peculiar gait, and unless treated ending fatally. 



Remarks. — ^This chapter should be read in conjunction with 

 Chapter XIX. (p. 380), in which we have outlined a new classification 

 of the trypanosomes with the view of crystallizing the knowledge 

 obtained up to date with regard to these parasites. In so doing we 

 have been compelled to introduce new terms, which we have made 

 as few as possible by utilizing those found in the literature with 

 which we are acquainted. Two of these new terms occur in this 

 chapter, because we have gone more fully into the trypanosomes of 

 man than into those of animals, because this is a work on tropical 

 medicine and not upon trypanosomes, and because those of man 

 are the forms which have been most satisfactorily studied. 



Chalmers has introduced the name Castellanella as the generic 

 name for the group of trypanosomes which includes the organisms 

 of sleeping sickness, because Castellanella castellanii (Kruse, 1903) — 

 synonym, Trypanosoma castellanii Kruse, 1903 — is the organism 

 upon which practically all the work in connection with sleeping 

 sickness was done prior to the discovery of C. rhodesiensis, which is 

 quite distinct from the other two forms. 



This is a point not generally recognized, nor is it realized that 

 though C. castellanii and C. gambiensis are morphologically alike, 

 they may be very different if studied carefully from a pathological 

 and serological point of view, as there is a suspicion that the well- 

 known difference in type between the milder form of the disease as 

 seen in portions of the West Coast of Africa and the severer as seen 

 in Uganda may not be due to acquired partial immunity, but to a 

 difference in the two organisms. 



In order to emphasize the necessity for further work with regard 

 to C. gambiensis, we have isolated it from C. castellanii. 



We would also point out that in the few papers in which compari- 

 sons have been made with regard to the pathological effects of 

 C. castellanii as found in sleeping sickness and C. gambiensis as 

 found in trypanosome fever, they both refer to C. castellanii 

 obtained from cases in Uganda showing at the time signs of sleeping 

 sickness or simply symptoms of trypanosome fever. 



