TRYPANOSOMES, TRYPANOSOMIASIS, AND SLEEPING SICKNESS 
decreased in numbers apparently due to the action of the dye. As the man returned to the Congo on the 
twenty-second day of treatment the administration of the substance had to be discontinued. The 
temperature had fallen somewhat and the patient appeared to have experienced no ill effects from it. The 
patient arrived at Leopoldville in September, 190^., and was at once put to work. Through an 
unfortunate misunderstanding treatment was not continued. Four months later the patient entered 
hospital with evident signs of sleeping sickness,' and died there in June, 1905. — }. L. T. 
Disasi. Male. Jet. 26. Lower Congo. 
Arrived in Liverpool, December 27, 1903. He and his wife had been found to be suffering from 
trypanosomiasis. His wife died on the voyage to England. 
Physical examination: A well-set-up sturdy man. Muscular development good, but inclined to 
obesity. Intelligence good ; no signs of being drowsy. Skin soft. Few chiggers in feet. General 
glandular enlargement. 
Respiratory system : normal. 
Circulatory system : Heart sounds not accentuated. Pulse, 98-101, of high tension, but regular. 
Spleen and Liver : Enlarged, not tender on palpation. 
Genito-urinary system normal. Urine, sp. gr. 1020. No albumen; no sugar; chlorides; 110 
bilirubin. 
Faeces contained Ankylostoma duodenale. 
Nervous system : Knee jerks normal. Epigastric, cremasteric reflexes not increased. Pupils reacted 
to accommodation and light. 
Ocular, nasal, and aural systems normal. 
The blood at first contained no trypanosomes — but Filaria perstans, often twenty-six to forty to a cover. 
Later, trypanosomes were very scanty ; the examination was often negative. On January 26 an attack of 
malaria occurred, the temperature reacting to quinine. 
February 6 : Thirty trypanosomes to a cover preparation were found ; these increased to eighty to a 
cover, and after four days decreased to seventy ; they then disappeared, to reappear again later and remain 
more constantly present, though in small numbers. From that time until May 7, except for slight colds 
and an occasional headache, nothing abnormal was remarked. Glandular enlargement had not become 
more pronounced. On Ma}' 8 he had coryza, and complained of pain in the right ear ; this increased in 
intensity. Examination revealed no mastoid tenderness or discharge from the ear. Signs of pneumonia 
appeared on May 10, and he was removed to Dr. J. Hill Abram's Ward in the Royal Infirmary. The 
disease progressed, and death occurred from pneumonia, May 14. 
For autopsy and morbid histology, see Part II, Disasi. 
Capt. S. B. Jet. 25. Italian. 
Patient was employed in the Congo Free State River Service. As he was suffering from trypano- 
somiasis and was leaving for Europe, Dr. Dutton recommended him to come to Liverpool. No definite 
history as to the date of infection could be ascertained : he had had several attacks of malaria. The first 
symptoms of irregular temperature, not reacting to quinine, and slight oedema of the legs were noticed about 
the end of 1901. Trypanosomes were found in his blood by Dr. Broden, in September, 1903. Patient 
was under the care of Dr. Lloyd Roberts in the Royal Southern Hospital from Ma) - 31 to June 18. 
Our notes of the case record nothing abnormal in the physical examination other than a very slight 
enlargement of one or two inguinal and cervical glands. The liver and spleen were slightly enlarged 
and palpable. No tenderness was evinced. There was no purpuric eruption, nor could oedema of an)" 
part be found while he was in Liverpool. The parasites were very scant}- in the blood. The 
temperature was of the usual type. 
B 
