TRYPANOSOMIASIS EXPEDITION TO SENEGAMBIA 
9 
Clinical Descriptions of Two Cases of Trypanosomiasis in Europeans 
Notes by Dr. H. E. Annett 
Case i. — H.K., an Englishman, aged forty-two, for six years in the Government 
employ as a master ot the Government steamer plying up the Gambia River, on the 
West Coast of Africa. 
The illness dated back from May, 1 901, when, after a period of heavy duties, 
he completely broke down and was admitted into hospital at Bathurst. There was a 
previous history of occasional attacks of malarial fever. It was during his stay in 
hospital at Bathurst that peculiar worm-like bodies were seen in specimens of blood, 
the nature ot which Dr. Forde was unable to recognize.* 
The illness was at first sight diagnosed as malarial fever, but, proving quite 
resistant to the administration of quinine, and presenting other peculiar characters, 
this diagnosis was abandoned. The peculiar symptoms were : ' irregular patches of a 
congested or cyanosed character appearing on different parts of the body, the colour 
slowly returning after pressure. An oedematous condition .... most marked on 
the face below the eyes, varying in degree from a scarcely noticeable swelling to 
well-marked puffiness : a condition also noticed in the lower part of both legs and 
around the ankles, but only in a slight degree. The respirations always .... from 
twenty to thirty, periodical accelerations occurring quite independently ot any rise in 
temperature, and whilst the patient was quietly lying in bed. The pulse was also 
accelerated, varying from seventy to one hundred and twenty. There seemed to be 
no relation between the rate and the temperature The beat was always strong 
and regular. The appetite was bad all the time, and though a fair amount of liquid 
nourishment was taken daily, the patient gradually lost weight and colour and became 
very emaciated. The liver and spleen were practically normal in size and position. 
The temperature was irregularly intermittent with two or three days ot normal or 
subnormal periods, and unaffected by any drugs.' 
After three weeks in hospital, K. was invalided home to England, and arrived 
in Liverpool in a very weak condition. Until August 12 he remained at home 
under the care ot his own medical attendant, and on that date was admitted into 
the Liverpool Royal Southern Hospital, under the care of Dr. Macalister. He 
complained of general weakness and lack of energy. Briefly, his chief symptoms 
and physical signs were : — 'Subnormal temperature ; slight headache, but no pain ; 
furred tongue ; fair appetite ; no vomiting ; constipation ; pulse (on admission), 
120, falling to about 92, regular in time and force, low tension, fair volume; heart 
sounds weak and distant, otherwise normal ; respiration (on admission), 32, falling 
later to 20 ; slight dyspnoea on exertion ; lungs normal ; weakness in legs ; some 
wasting ; knee jerk and plantar reflexes present and easily obtainable ; sensation 
* Thompson Yates Laboratories Report, 1902, Vol. IV, Part ii. 
C 
