Page:The Journal of Tropical Medicine, volume 6.djvu/233
ORIGINAL COMMUN ICATIONS.
ping Sickness in the Light of Recent Knowledge.
) _ By Loos W. Samzox, M.D. (Naples) 201
ne Dengue: A Study of its Pathology and Mode of
a . By Dr. H. Granam .. 209
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Che Fournal of Cropical ADecdicine. CONTENTS.—JULY Ist, 1903. EDITORIAL. PAGK Papers Relating to the Investigation of Malaria and other Tropical Diseases, and the Establishment of
Schools of Tropical Medicine . . 215 Sir Patrick Manson, K.C.M.G., F.R.S. 216 Tropical Hygiene. By W. J. Simpson, M.D., F.R.C.P. 217 Notes and News 219 Recent and Current Literature 219 Original Communications.
SLEEPING SICKNESS IN THE LIGHT OF RECENT KNOWLEDGE.
By Louts W. Samson, M.D. (Naples). Lecturer to the London School of Tropical Medicine.
Ede over a century the mysterious sJeeping sick- of Africa has been known to Europeans. It lurked
n the back-country of the West Coast, between the enegal and the Quanza, and, at the time of the slave rad hundreds of negroes, raided from the interior, d of it on board transport ships, or in the planta-
of the Antilles. But theidisease did not give
g ¢ to any apprehension ; it was believed to be strictly on aaa to the negro race, it did not spread in the s to which it was imported, and was universally
f ded as a peculiar form of nostalgia. Qui Quite recently, possibly in consequence of the great stir which the advent of the white man has eated amongst the native tribes of Tropical Africa, ping sickness has begun to spread very widely, and s assumed a fearful importance in the pathology of p Dark Continent. Within the last few years it has mded southward throughout Angola, it has spread th Miser and the Congo, and, proceeding along the
routes opened up by Kuropeans, it has appeared im East Central Africa, invading Nile and the shores and islands of the equa- ces. In Northern Angola, on the upper Congo,
ain districts of Uganda, its ravages have already
en ling. In many places entire villages ieee en 7, lated. In the Busogo province alone 000 natives have succumbed within the last three
- ‘hs e appearance of sleeping sickness in the very heart
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e of Africa, its steady, widening progress, call for very serious consideration and for immediate action. The disease is quite likely to follow the Nile and menace Egypt. or, reaching the East Coast, it may possibly find its way into India. However, it is not merely its tendency to spread which brings sleeping sickness so forcibly before us, but its terrible, inexorable deadliness. The sleeping sickness of Africa is invariably fatal.
Heretofore, sleeping sickness has been looked upon as a disease of the negro race exclusively, but a number of cases have been reported in half-breeds, and two or three doubtful cases in Europeans. So far the cases amongst Europeans have been disbelieved, chiefly on account of erroneous @ priori arguments. Latterly, our ideas concerning the relation between race and disease have been totally changed. We know, now, that there are no purely ethnic diseases. At one time it was believed that the dark races were far more liable to elephantiasis than the white, now, we kaow that when Europeans are placed exactly in the same con- ditions as the natives they are quite as liable to acquire it. I have no doubt the same is the case in sleeping sickness.
SYMPTOMS. The symptoms of sleeping sickness are fairly well known. Clarke, Dangaix,? Nicolas,’ Santelli, Guérin,’ McCarthy,’ Corre,’ Abblart,* Forbes,’ Bettencourt,” Cook" and Hodges” have given us excellent descriptions of the disease as it occurs in various parts of Atrica, and Mackenzie and Manson’ have very carefully described three cases of the disease in Congo natives brought over to England for the express purpose of accurate investigation. Two of the latter cases I hac the opportunity of watching myself.
A striking feature in sleeping sickness is the long duration of its incubation period. At times, the disease in its characteristic somnolent stage may not manilest