22 THOMPSON YATES AND JOHNSTON LABORATORIES REPORT 
Heart dilated, both sides contained large, firm, white agonal clots. Valves normal. In left ventricle 
was small area of sub-endocardial petechial haemorrhage. Several pin-head calcareous nodules along 
cardiac veins. 
Lungs : Weight, right, 227 grammes ; left, 151 grammes. Both show profuse sub-acute bronchitis ; 
bronchi full of mucous. 
Abdomen : Omentum drawn up and wrapped around spleen, small clot of blood between it and 
outer surface of spleen due to puncture. Peritoneum contained no fluid. Old adhesions between 
transverse colon and gall bladder. 
Liver : Weight, 6S2 grammes. Yellow, slight interlobular congestion. Gall-bladder full of dark- 
green semi-fluid bile. 
Sj>/een : Weight, 228 grammes ; enlarged, anterior border very much notched ; substance very 
diffluent and dark red in colour. One small spleniculus. 
Kidneys : Weight (together), 1 5 1 grammes ; normal. Bladder normal, rilled with urine. 
Genitals normal, save for left tube bound down in Douglas' pouch by firm fibrous adhesions 
Child has menstruated, remnants only of lu men. 
Intestines normal, few anchylostomes in ileum. 
Bone marrow (tibia), reddish orange in colour. 
Brain : Dura not adherent to calvarium or pia. Superficial brain vessels much congested, vessels 
of basal ganglia very much so. There was fair amount of colourless, slightly turbid, sub-dural and sub- 
arachnoid fluid. Similar fluid occurred in ventricles and escaped from vertebral canal. No trypanosomes 
were seen in these fluids. 
Lymbhatic glands : Generally much enlarged, often oedematous, usually greatly congested and, in 
the abdominal and thoracic groups, haemorrhagic, sometimes excessively so. There were numerous 
patchy areas of dark sub-capsular pigmentation in the femoral and axillary groups. 
Case 64. Dysiki. Female. Age twenty-six. 
History. — Patient is from Lusambo, in the Kasai district, where sleeping sickness 
is said to be prevalent. She has been in Leopoldville for two-and-a-half years. 
Her illness is said to have commenced one-and-a-half months ago. Entered hospital 
because ' feet were sick and had difficulty in walking.' 
December 8. General condition. Patient is very thin, expression somewhat 
dull and vacant, intelligence good, answers questions fairly quickly, muscles are 
wasted, and great weakness is apparent in her unsteady walk ; speech clear, but 
weak ; eyes very prominent ; lips puffy, dry, and cracked. Skin is dry, dirty, and 
scurf}'. There is distinct pitting of shins and dorsa of feet but not of face or fore- 
head. Lymphatic glands, all enlarged. Physical examination of abdomen and 
thorax showed no abnormality. Nervous system, co-ordination and muscular sense 
good, reflexes only just obtainable. Alimentary system : tongue steady, slightly 
furred, teeth and gums normal, appetite good, bowels regular. 
December 15 to 19. Patient is very weak, sits most of the day outside the hut. 
Sleeps but very little, likes to sit in the sun. 
December 21. Extremely weak, passes faeces in blanket without changing 
position. Prominence of eyes (ocular tension increased) and puffi'iess of eyelids 
and lips persists. 
