TRYPANOSOMES, TRYPANOSOMIASIS, AND SLEEPING SICKNESS 5 
seen. Part of the cerebrospinal fluid was inoculated into a monkey, two rats, and a rabbit. The boy 
was kept in bed, though he said he felt well. The next da}' he was found in a semicomatose state. 
Temperature, 96-4° P. ; respiration, 19 ; pulse, 108. Deviation of the eyes was noted. He was taken to 
the Royal Southern Hospital, and placed under the care of Dr. Lloyd Robkrts. Until he died, on 
June 17, he remained in a somnolent state. At first nourishment in the form of soup could be given, 
but later total unconsciousness intervened. There was incontinence of urine and faeces. The 
temperature was sub-normal, but started to rise on the evening of the 1 6th, registering iocr6° F. at 
death. The reflexes were all decreased : sensations dulled. The pupils reacted to accommodation and 
light. The parasites continued to increase in numbers — a few hours before death two to three to a field 
were seen. 
The differential blood counts made on two different days gave the following results : — 
June 1 1 
June 16 
Polymorphonuclear neutrophile ... 
77-63 
76-00 
Large mononuclears 
+ ■'5 
••' 
Lymphocytes 
IO77 
I I -2 
Eosinophiles 
+ 71 
Transitional forms 
2-I + 
T 2 
Mast cells 
c-6o 
0-7 
1 ooxo 
1 OO'O 
Trypanosomas 
Absent 
1 to 2 to a field 
For autopsy, etc., see Part II, Tomi. 
Boyo Mitchel. Male. Aet. 14. Coquilhatville. 
First seen January 21, 1904. Came to Leopoldville two years ago. First felt ill coming down the 
Kasai river two or three months since, when he had headaches. 
February 5 : Thin and wasted. Gait slow, unsteady, and shuffling. Expression dull, apathetic, 
and vacant. Answers questions slowly and in a weak voice. Very drowsy. 
P/iysical condition : Skin dry and scurfy. Glands enlarged. No oedema. Slight puffiness about 
eyes and puffy appearance of whole of face. Mouth full of sores. 
Heart and Lungs normal. 
Spleen not enlarged. 
Liver apparently enlarged. 
Knee jerks normal. Epigastric and cremasteric reflexes normal. 
Faeces contain anchylostoma and ascarides. 
Up to time of departure lor England the boy remained in about the same state. Tremors being 
marked at times. 
May 13 : He walked with difficulty to the steamer. Temperature, 104101- two days; patient in 
state of collapse ; could eat nothing. Urine and faeces passed in bed. After two days at sea he revived 
a little ; the temperature fell and he was able to sit on deck. Mouth very foul. Later he was unable to 
get out of his bunk. Could only take soup and water if fed with a spoon 
