HUMAN TRYPANOSOMIASIS ON THE CONGO 
{Being the First Progress Report of the Expedition of the Liverpool School 
of Tropical Medicine to the Congo, 1903)* 
BY 
J. EVERETT DUTTON, M.B., Vict. 
j. L. TODD, B.A., M.D., CM., McGill 
AND 
CUTHBERT CHRISTY, M.B., Edin. 
AT the request of His Majesty King Leopold II, King of the Belgians, this 
expedition was sent in September last to the Congo Free State to report upon 
the sanitation of the larger towns, and to continue the School's work on 
human trypanosomiasis. Through the kindness of the Governor-General of the 
Congo, and of Drs. Vourloud and Niulseng, government physicians at Boma, the 
hospital for natives at Boma was opened to us. It contained about sixty-five patients, 
and we saw there! eighteen patients who had been admitted as cases of sleeping 
sickness. 
Whether admitted to hospital by the medical officers, or pointed out to us by 
the missionaries as cases of sleeping sickness, with three or four exceptions, the cases 
which we have as yet seen have been, in our opinion, very unlike what has hitherto 
been described as sleeping sickness. Continued sleep or even abnormal sleep has 
been almost absent from many of the cases. It has been absent even in those who 
were believed to be in an advanced stage of the disease and who ultimately died. In 
only three or four of the cases observed by us has somnolence been a marked feature, 
and only in these few cases have the symptoms in any way coincided with those 
observed by one of us during the Uganda epidemic of sleeping sickness. 1 
From November 4 to November 29 two of us were occupied in travelling 
through the cataract region, in order to ascertain for ourselves the exact conditions 
existing there. Reports sent to the Congo Free State officials, and handed on to us, 
as well as correspondence received by ourselves, led us to believe that in this district 
we should find, not only an epidemic of sleeping sickness, but that the whole 
population was being 'decimated ' by the disease. Although, in the course of our 
* Reprinted by j-ermiss'on of the publishers of the British Mkdical Journal, January 23, 1904 
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