TRYPANOSOMIASIS EXPEDITION TO THE CONGO 
J 7 
Case 94. Kassongo. Male. Age twenty-three. 
History. — A Batetela man. Has been for two years in Leopoldville as State 
labourer. Patient says that he never had fever. 
February 23, 1904. General condition : Is a well-nourished, intelligent man, 
answers questions quickly and well. Has a stolid expression, but no dulness or 
vacancy whatever, actions not markedly slow. Oedema absent, no puffiness of face. 
Skin smooth and glossy. Lymphatic glands, all easily palpable, freely movable and 
hard ; parotids enlarged. Patient believes himself to be in perfect health. A careful 
physical examination reveals nothing abnormal in thorax or abdomen. 
Nervous system. Co-ordination and sensation to touch and pain normal ; super- 
ficial and deep reflexes, normal ; pupils react to accommodation and light ; no 
tremors. 
March 31. Physical examination repeated. With exception of a distinctly 
accentuated aortic second sound patient seems to be absolutely normal. He works 
willingly and well all day long. 
TYPE ' B ' 
Cases, Intermediate Between Types ' A ' and ' C,' showing very few signs 
of Illness, and not yet Definitely Believed by Their Friends to re 
Suffering From Sleeping Sickness. 
Case 46. M'Pangila. Age seventeen. Male. 
History. — Patient is a Lower Congo native. At age of thirteen he was admitted 
to the Baptist Mission Station at Wathen, Cataract Region. Here he was successively 
employed as garden boy, table boy, goat herd, and at the age of fifteen as cook. In 
December, 1902, he complained of fatigue while on the march, and was soon after 
dismissed because of untidy careless habits. His employers had at this time only a 
vague suspicion that these might be the prodromal symptoms ot sleeping sickness. 
He had not since been seen until November 13, 1903, when, with another youth, he 
carried into the Mission a sick child from a village four-and-a-half hours distant. 
The only changes perceived in the lad were that much less care was taken of his 
personal appearance than formerly, and he was not so robust. 
November 14, 1903. General condition. Patient is thin and has a certain, 
apathetic stolidity or dulness of expression. Oedema absent. Skin is soft and clean 
but dry. Lymphatic glands all considerably enlarged. Physical examination reveals 
nothing abnormal. Pulse, 96-1 10. Respiration, 20-24. 
Temperature, with the exception of an evening rise to occasionally 99"5° F., is 
almost normal. Patient was sent to England, December 4, 1903. His condition 
since he has been under observation in Liverpool has not yet been ascertained. 1 
1. August, 1904, condition remains the same —parasites present in the blood. 
D 
