TRYPANOSOMIASIS EXPEDITION TO SENEGAMBIA 
*9 
soon have them cut out as a prevention against sleeping sickness.* The boy main- 
tained that he was perfectly well. 
Clinical Examination showed a sturdily built lad. All his organs were normal 
except the spleen, which could be felt 6-5 cm. below costal margin. There was no 
tenderness on palpation. 
The axillary, inguinal, sternomastoid, and submaxillary lymphatic glands were 
all very much enlarged, not tender, hard, and freely movable. One in the left 
axilla was the size of a pigeon's egg. 
Pulse varied in frequency, was usually about 112 ; respiration, 26 ; tempera- 
ture 101 0 F. 
Blood. — Was examined on two consecutive days. The first observation 
showed one parasite to coverslip ; at the second six were seen. 
Differential count of Leucocytes 
Neutrophils - - 29*50 per cent. 
Eosinophiles 8-87 per cent. 
Mast cells - - - 0*25 per cent. 
Mononuclear small cells, 46-26 per cent. — Lymphocytes - 41*64 per cent. 
,, with irregular 
nuclei, 4*62 per cent. 
Mononuclear large cells, 15-12 per cent. — Large lymphocytes, 9-12 per cent. 
Large mononuclears, 0-50 per cent. 
Transitionals - 5-5 per cent. 
ioo-oo 
Eight hundred cells were counted from two slides. 
Case 5. — A Jollof Mohammedan man, age thirty-five years, living at Kuntur, 
a riverside village in McCarthy district. 
History. — He was born at Bantanding, near Barra Point, but as a child 
lived in Bathurst. 
He was at the age of fourteen years apprenticed as a sailor to one of the 
cutters plying on the Gambia River and worked up to be a captain. 
For the past five years he had lived at Kuntur all the year round, working 
at one of the ground-nut ' factories.' 
He had never had any serious illness, but at times had had what he called 
'strong fever,' generally in the morning, lasting for three or four hours. Last rainy 
season he was laid up with headache and ' fever ' for three days ; he said he had 
never had headache before, and at the time noticed his ' eyes ' were swollen. The 
swelling of the left eye persisted for two weeks. 
* The Gambian natives recognize sleeping siclcness, and assert that they can foretell its onset. They believe that an 
invariable prodrome is an enlargement of the lymphatic glands, particularly of the anterior cervical and sub-maxillary groups. 
The excision of enlarged glands, to prevent sleeping sickness, is one of their few surgical operations. 
