8o V. JANUARY TO JUNE, 1914 
a regular, if small, number of victims, and then it may 
begin to rage again as destructively as before. 
The first symptom consists of irregular attacks of 
fever, sometimes light, sometimes severe, and these 
may come and go for months without the sufferer feeling 
himself really ill. There are victims who enter the 
sleep stage straight from this condition of apparent 
health, but usually severe headaches come during the 
fever stage. Many a patient have I had come to me 
crying out : “ Oh, doctor ! my head, my head ! I 
can’t stand it any longer ; let me die ! ” Again, the 
sleep stage is sometimes preceded by torturing sleepless- 
ness, and there are patients who at this stage get 
mentally deranged ; some become melancholy, others 
delirious. One of my first patients was a young man 
who was brought because he wanted to commit suicide. 
As a rule, rheumatism sets in with the fever. A 
white man came to me once from the N’Gomo lake 
district suffering from sciatica. On careful examina- 
tion, I saw it was the beginning of the sleeping sickness, 
and I sent him at once to the Pasteur Institute at Paris, 
where French sufferers are treated. Often, again, an 
annoying loss of memory is experienced, and this is 
not infrequently the first symptom which is noticed 
by those around them. Sooner or later, however, 
though it may be two or three years after the first 
attacks of fever, the sleep sets in. At first it is only 
an urgent need of sleep ; the sufferer falls asleep 
whenever he sits down and is quiet, or just after 
meals. 
A short time ago a white non-commissioned officer 
from Mouila, which is six days’ journey from here, 
visited me because, while cleaning his revolver, he had 
