90 THOMPSON YATES AND JOHNSTON LABORATORIES REPORT 
to post-mortem contamination. The cases died during the summer months ; the 
earliest autopsies were performed four hours after death. 
We may draw attention to the fact that large quantities of pure blood or 
cerebro-spinal fluid taken during life from these cases were inoculated intraperitoneally 
into monkeys, guinea-pigs, rats, and mice, and intravenously into rabbits without 
causing any septic infection. As much as twenty c.c. of pure blood has been inocu- 
lated, and cerebro-spinal fluid in the amount of ten c.c. Cultures were also made 
from the blood and cerebro-spinal fluid of two of the cases of sleeping sickness, and 
were negative, with the exception of one or two tube and flask cultures, which showed 
a growth of Staphylococcus albus. 
Undoubtedly a large number of sleeping sickness cases do not die from the 
original infection, but rather from some secondary infection, such as pneumonia, 
septic meningitis, etc., caused either through septic processes starting in the oral or 
nasal cavities or due to the generally debilitated condition, a result of the trypano- 
some infection. Among the experimental animals a heavy mortality occurs when any 
epidemic occurs among them. Haemorrhagic lymph glands have been described by 
Dutton, Todd, and Christy in their series of sleeping sickness cases. The two 
first observers have also described such glands in their experimental animals infected 
with T. gambiense and T. dlmorphon (Senegambia report). 
In all the three cases of sleeping sickness, and in the case of trypanosomiasis, 
and in many of the experimental animals infected with T . gambiense and T. dimorphon, 
haemorrhagic lymph glands have been found. These glands have all the characters 
of the haemo-lymph glands, as described by Robertson, Clarkson, Vincent and 
Harrison, Warthin, Dalton, Kelly, and other observers. These authors describe 
them as normally present, but in small numbers, in human beings and animals, and 
always in the neighbourhood of large blood vessels. We find that these glands are 
present in large numbers, and all stages between normal and haemo-lymph glands are 
to be seen, especially in the human cases. Necrotic areas were present in the spleens 
of our human cases and some of the animals. The spleens of all were intensely 
congested. Blood pigment giving the iron reaction has been found in the spleen and 
glands of these cases. It would seem from all these facts that an extensive destruction 
of the blood corpuscles occur and, as the bone-marrow is always degenerated, that there 
is not a sufficient formation of new cells. 
Animals infected with various strains of trypanosomes derived from sleeping 
sickness and trypanosome fever cases show similar changes in their nervous system 
and organs as those described in sleeping sickness cases ; and these changes depend 
largely on the duration of the disease ; and, moreover, similar changes are described 
above in animals intected with T. dimorphon (but only after the disease has 
continued for a long time). Further, Sivori and Lecler describe in their paper, 
La Surra Americane (Mai de Caderas), haemorrhagic areas in the grey substance of 
