TRYPANOSOMIASIS EXPEDITION TO THE CONGO 
15 
It is significant to note that a large percentage — thirty-six out of forty-four of 
those classed under types B and C — were believed by their friends to be suffering 
from ' sleeping sickness.' 
We have seen cases coming under type C in which no sleep symptoms were 
ever present, as well as cases in which some of the diagnostic signs of classical 
sleeping sickness were noted. 
We therefore subdivide type C into : — 
1. Fatal cases showing no sleep symptoms. 
2. Fatal cases showing sleep symptoms. 
Here again no sharp division is possible between these two groups, still, we 
think it not inadvisable to separate them, since, from our experience here we believe 
that altogether too much prominence, as a diagnostic feature, has been given to what 
appears to us to be only a minor and inconstant feature of this disease, namely sleep. 
The prominence given to this symptom has tended to disguise the true nature of 
Congo Sickness which is, primarily at least, a trypanosome infection. 
The following charts and abstracted clinical reports will illustrate the characteris- 
tics of the Congo disease. 
TYPE ' A ' 
Cases with no Definite Symptoms of Illness 
Case 79. Fariala. Male. Age thirty. 
History. — Admitted to hospital for chronic ulcer of thigh, January 7. Is from 
Lukila, Kasai district ; has been for ten years in the neighbourhood of Leopoldville. 
January 17. General condition. Is a well-nourished, sturdy man ; intelligence 
good, answers questions quickly and well, shows no unsteadiness of gait, and com- 
plains of nothing save the ulcer. Skin is dry and dirty ; there are several large 
scars and cicatrices on knees, ankles, and elbows, said to be due to injuries and burns. 
Face is pitted by smallpox. Slight oedema of right shin, probably due to old 
cicatrix. 
Lymphatic glands are all enlarged. Circulatory system : heart, position and 
dulness normal, loud mitral systolic bruit, aortic second sound accentuated. 
Respiratory system : normal. Alimentary system : tongue, teeth, and mouth normal ; 
bowels regular. 
Liver and spleen not enlarged. Nervous system : co-ordination perfect, super- 
ficial and deep reflexes normal, pupils react to accommodation and light. 
January 25. Complains of nothing, and, save for ulcer, seems quite well. 
Blood shows filaria diurna, filaria perstans, and trypanosomes. 
March 31. Patient at work, and apparently in good health. 
