84 THOMPSON YATES AND JOHNSTON LABORATORIES REPORT 
bacilli and large cocci, which did not stain by Gram's method, in all the organs. 
They are to be regarded as the result of post-mortem contamination. 
Trypanosomes were not seen either in the organs or in the central nervous 
system. 
D. — The Fourth Case, Disasi 
Well-built, with a fair amount of adipose tissue. Externally, nothing of note. 
Brain and coverings normal. Right tympanic cavity filled with pus. The whole of 
right lung consolidated. The lower part of the left upper lobe with the upper part 
of the lower lobe were congested, and showed small haemorrhages in the pleura. 
Liver somewhat enlarged and congested. 
Kidneys normal. 
Spleen enlarged. Capsule thickened. On cross section the pulp was found soft 
and showed no particular changes. 
All the lymphatic glands were enlarged, some being dark-red with pin-head sized 
grey patches here and there. 
The mucous membrane of stomach and intestines pale ; jejunum contained a 
few ankylostomes. 
Microscopical Examinations. — Sections of the lungs showed typical fibrinous 
pneumonia and very numerous diplococci, staining by Gram. 
The spleen was very congested. 
The lymph glands presented the same conditions as in the sleeping sickness cases, 
only they contained far more free blood corpuscles among the lymphoid tissues. The 
examination of the brain and cord did not show any of those changes which were found 
in the sleeping sickness cases, although a large number of sections of different parts 
were examined. The perivascular lymph spaces were much dilated. There was 
neither haemorrhage nor small-celled infiltration in them, but they were often filled with 
transudation fluid containing one or two free lymphocytes. The large nerve cells 
only showed such changes as are caused by hyperthermia. 
The cerebral vessels contained a large number of diplococci staining by Gram, 
and here, as well as in the tissues of the brain itself as in that of the cord, were a 
great number of large bacilli in small clumps and short chains, not staining by Gram. 
