SLEEPING SICKNESS 
85 
Libreville, without any being discovered, and it was 
only in the Sleeping Sickness Institute at Brazzaville 
that they were a second time proved to be there. 
If, then, I wish to treat such patients conscientiously, 
a couple of them together can tie me for a whole morn- 
ing to the microscope, while outside there are sitting a 
score of sick people who want to be seen before dinner- 
time ! There are also surgical patients whose dressings 
must be renewed ; water must be distilled, and medi- 
cines prepared ; sores must be cleansed, and there are 
teeth to be drawn ! With this continual drive, and the 
impatience of the waiting sick, I often get so worried 
and nervous that I hardly know where I am or what I 
am doing. 
Atoxyl is a frightfully dangerous drug. If the solu- 
tion is left for some time in the light it decomposes, 
just like salvarsan, and works as a poison, but even if 
it is prepared faultlessly and is in perfect condition, it 
may cause blindness by injuring the nerves of sight. 
Nor does this depend on the size of the dose ; small 
ones are often more dangerous than large ones, and they 
are never of any use. If one begins with too small a dose, 
in order to see whether the patient can take the drug, the 
trypanosomes get inured to it ; they become “ atoxyl- 
proof,” as it is called, and then can defy the strongest 
doses. Every five days my sleeping sick come to me 
for an injection, and before I begin I always ask in 
trepidation whether any of them have noticed that their 
sight is not as good as usual. Happily, I have so far 
only one case of blinding to record, and that was a man 
in whom the disease had already reached a very 
advanced stage. Sleeping sickness now prevails from 
the east coast of Africa right to the west, and from the 
