5
INTRODUCTORY.
Since the departure of Colonel D. Bruce, F.R.S., for England on August 28, 1903, the work of the Commission was carried on by Greig and Nabarro until November 20, 1903. On that date Dr. Nabarro left Entebbe for England. The work of the Commission was conducted by Captain Greig until he was joined on March 9, 1904, by Lieutenant A. C. H. Gray, R.A.M.C.
Captain Greig left Entebbe for England on November 15, via the Nile and Egypt.
This Continuation Report brings the work of the Commission up to the date of Greig’s departure for England.
In this Report evidence is brought forward which affords additional proof of the correctness of the conclusions arrived at in the last Report. Further evidence is brought forward to show:—
1. That the disease is at first a specific polyadenitis
caused by the Trypanosoma garnbiense.
2. That in addition to enlargement of lymphatic glands
the blood shows a constant lymphocytosis at all stages of the disease.
3. That Sleeping Sickness is the last stage of this disease,
and is invariably fatal. It consists essentially in a polyadenitis plus signs and symptoms due to changes in the nervous system ; the onset of these signs and symptoms synchronises with the entrance of the Trypanosoma garnbiense into the lymph spaces of the nervous system ; this is accompanied by a rise of the mononuclear elements in the cerebro-spinal fluid.
4. That the resistance of both men and monkeys to the
Trypanosoma garnbiense, as judged by the duration of the early stage, varies greatly, and probably a certain proportion, not yet exactly determined, acquire sufficient immunity to arrest the development of the disease at that stage.
5. That the action of arsenic in vita on the Trypanosoma
garnbiense is partial. It destroys a number of the trypanosomes, and probably these act as immunising agents. Its administration in the stage of polyadenitis tends to help the natural resistance to combat the disease.
6. That bacterial invasion, chiefly coccal, occurs in some
cases, but only in the very last days of the sleeping sickness stage, and therefore cannot determine the onset of this phase of the malady.